Provider Demographics
NPI:1417491267
Name:CENTRO HOLISTICO PARA EL BIENESTAR DE LA SALUD MENTAL
Entity Type:Organization
Organization Name:CENTRO HOLISTICO PARA EL BIENESTAR DE LA SALUD MENTAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FREELANCE TERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:NILDA
Authorized Official - Middle Name:MARGARITA
Authorized Official - Last Name:COLON RIVERA
Authorized Official - Suffix:
Authorized Official - Credentials:MBA, LMT
Authorized Official - Phone:787-210-2222
Mailing Address - Street 1:C9 AVE LUIS MUNOZ MARIN
Mailing Address - Street 2:URB. CAGUAX
Mailing Address - City:CAGUAS
Mailing Address - State:PR
Mailing Address - Zip Code:00725-3330
Mailing Address - Country:US
Mailing Address - Phone:939-204-9052
Mailing Address - Fax:
Practice Address - Street 1:C9 AVE LUIS MUNOZ MARIN
Practice Address - Street 2:URB. CAGUAX
Practice Address - City:CAGUAS
Practice Address - State:PR
Practice Address - Zip Code:00725-3330
Practice Address - Country:US
Practice Address - Phone:939-204-9052
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-12-13
Last Update Date:2016-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR00-71261QM0850X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health