Provider Demographics
NPI:1497177372
Name:SERVICIOS PSICOLOGICOS LLC
Entity Type:Organization
Organization Name:SERVICIOS PSICOLOGICOS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ARACELI
Authorized Official - Middle Name:
Authorized Official - Last Name:PERONA
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:787-391-0044
Mailing Address - Street 1:220 PLAZA WESTERN AUTO STE 101
Mailing Address - Street 2:PMB 400
Mailing Address - City:TRUJILLO ALTO
Mailing Address - State:PR
Mailing Address - Zip Code:00976-3607
Mailing Address - Country:US
Mailing Address - Phone:787-391-0044
Mailing Address - Fax:787-622-4432
Practice Address - Street 1:RIO PIEDRAS HEIGHTS - TINTO ST. 1733
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00926-0000
Practice Address - Country:US
Practice Address - Phone:787-622-4433
Practice Address - Fax:787-622-4432
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-13
Last Update Date:2014-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR002079261QM0850X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health