Provider Demographics
NPI:1558715870
Name:CAMUY HEALTH SERVICES, INC.
Entity Type:Organization
Organization Name:CAMUY HEALTH SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FINANCE ASSITANT
Authorized Official - Prefix:MR
Authorized Official - First Name:JUAN
Authorized Official - Middle Name:
Authorized Official - Last Name:SOTO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-262-6603
Mailing Address - Street 1:63 MUNOZ RIVERA AVENUE
Mailing Address - Street 2:
Mailing Address - City:CAMUY
Mailing Address - State:PUERTO RICO
Mailing Address - Zip Code:00627
Mailing Address - Country:UM
Mailing Address - Phone:787-262-6603
Mailing Address - Fax:787-262-6603
Practice Address - Street 1:63 AVE MUNOZ RIVERA E
Practice Address - Street 2:
Practice Address - City:CAMUY
Practice Address - State:PR
Practice Address - Zip Code:00627-2630
Practice Address - Country:US
Practice Address - Phone:787-262-6603
Practice Address - Fax:787-262-1210
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CAMUY HEALTH SERVICES, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-04-22
Last Update Date:2016-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR33101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR0082062Medicare PIN