Provider Demographics
NPI:1558571232
Name:ASSMCA
Entity Type:Organization
Organization Name:ASSMCA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ASISTENTE PSICOSOCIAL
Authorized Official - Prefix:MISS
Authorized Official - First Name:CLARISSA
Authorized Official - Middle Name:TORRES
Authorized Official - Last Name:MATOS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-833-3675
Mailing Address - Street 1:HC 2 BOX 12910
Mailing Address - Street 2:
Mailing Address - City:SAN GERMAN
Mailing Address - State:PR
Mailing Address - Zip Code:00683-9638
Mailing Address - Country:US
Mailing Address - Phone:787-892-8693
Mailing Address - Fax:
Practice Address - Street 1:HC 2 BOX 12910
Practice Address - Street 2:
Practice Address - City:SAN GERMAN
Practice Address - State:PR
Practice Address - Zip Code:00683-9638
Practice Address - Country:US
Practice Address - Phone:787-892-8693
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR=========Medicare ID - Type Unspecified