Provider Demographics
NPI:1477943207
Name:CORRECTIONAL HEALTH SERVICES CORPORATION
Entity Type:Organization
Organization Name:CORRECTIONAL HEALTH SERVICES CORPORATION
Other - Org Name:CHSC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PSICOLOGA CLINICA
Authorized Official - Prefix:DR
Authorized Official - First Name:REBECA
Authorized Official - Middle Name:CHRISTINA
Authorized Official - Last Name:HERNANDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:PSY D
Authorized Official - Phone:787-632-3942
Mailing Address - Street 1:235 CALLE MIGUEL RIVERA TEXIDOR
Mailing Address - Street 2:ESTANCIAS DEL GOLF
Mailing Address - City:PONCE
Mailing Address - State:PR
Mailing Address - Zip Code:00730
Mailing Address - Country:US
Mailing Address - Phone:787-632-3942
Mailing Address - Fax:787-841-6127
Practice Address - Street 1:235 CALLE MIGUEL RIVERA TEXIDOR
Practice Address - Street 2:ESTANCIAS DEL GOLF
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00730-0530
Practice Address - Country:US
Practice Address - Phone:787-632-3942
Practice Address - Fax:787-841-6127
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-02
Last Update Date:2015-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR2484261QH0100X, 261QM0850X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health