Provider Demographics
NPI:1427201078
Name:ASSMCA
Entity Type:Organization
Organization Name:ASSMCA
Other - Org Name:ADMINISTRACION SE SERVICIOS DE SALUD MENTAL Y CONTRA LA ADICCION
Other - Org Type:Other Name
Authorized Official - Title/Position:CLINICAL SOCIAL WORKER
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:RAFAEL
Authorized Official - Last Name:PLA
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:787-550-4290
Mailing Address - Street 1:UU45 CALLE YUNQUESITO
Mailing Address - Street 2:
Mailing Address - City:CAROLINA
Mailing Address - State:PR
Mailing Address - Zip Code:00987-8125
Mailing Address - Country:US
Mailing Address - Phone:787-550-4290
Mailing Address - Fax:
Practice Address - Street 1:UU45 CALLE YUNQUESITO
Practice Address - Street 2:
Practice Address - City:CAROLINA
Practice Address - State:PR
Practice Address - Zip Code:00987-8125
Practice Address - Country:US
Practice Address - Phone:787-550-4290
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-28
Last Update Date:2008-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR9346261QM0855X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health