Provider Demographics
NPI:1467742650
Name:INSPIRA BEHAVIORAL CARE
Entity Type:Organization
Organization Name:INSPIRA BEHAVIORAL CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINIC SOCIAL WORKER
Authorized Official - Prefix:MISS
Authorized Official - First Name:ALVARADO
Authorized Official - Middle Name:AIMEE
Authorized Official - Last Name:MARTINEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MSW
Authorized Official - Phone:787-595-0348
Mailing Address - Street 1:PO BOX 122
Mailing Address - Street 2:
Mailing Address - City:COAMO
Mailing Address - State:PR
Mailing Address - Zip Code:00769-0122
Mailing Address - Country:US
Mailing Address - Phone:787-595-0348
Mailing Address - Fax:
Practice Address - Street 1:184 CALLE GUADALUPE
Practice Address - Street 2:
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00730-3561
Practice Address - Country:US
Practice Address - Phone:787-709-4134
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-09
Last Update Date:2011-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR10397283Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes283Q00000XHospitalsPsychiatric Hospital