Provider Demographics
NPI:1427189489
Name:JG PSYCH SERVICES, PSC
Entity Type:Organization
Organization Name:JG PSYCH SERVICES, PSC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JORGE
Authorized Official - Middle Name:
Authorized Official - Last Name:GONZALEZ BARRETO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-854-6105
Mailing Address - Street 1:PO BOX 264
Mailing Address - Street 2:
Mailing Address - City:MANATI
Mailing Address - State:PR
Mailing Address - Zip Code:00674-0264
Mailing Address - Country:US
Mailing Address - Phone:787-854-6105
Mailing Address - Fax:787-854-1573
Practice Address - Street 1:J4 CALLE HERNANDEZ CARRION
Practice Address - Street 2:URB. ATENAS
Practice Address - City:MANATI
Practice Address - State:PR
Practice Address - Zip Code:00674-4623
Practice Address - Country:US
Practice Address - Phone:787-854-6105
Practice Address - Fax:787-854-1573
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health