Provider Demographics
NPI:1417256231
Name:CAYEY COMMUNITY HEALTH CLINIC
Entity Type:Organization
Organization Name:CAYEY COMMUNITY HEALTH CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:M
Authorized Official - Last Name:NIEVES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-316-2875
Mailing Address - Street 1:PO BOX 4985
Mailing Address - Street 2:PMB 103
Mailing Address - City:CAGUAS
Mailing Address - State:PR
Mailing Address - Zip Code:00726-4985
Mailing Address - Country:US
Mailing Address - Phone:787-316-2875
Mailing Address - Fax:
Practice Address - Street 1:CALLE LUIS BARRERAS #10
Practice Address - Street 2:
Practice Address - City:CAYEY
Practice Address - State:PR
Practice Address - Zip Code:00736-0000
Practice Address - Country:US
Practice Address - Phone:787-316-2875
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-18
Last Update Date:2011-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service