Provider Demographics
NPI:1609162643
Name:CENTRO YAHVEH-RAFA EVALUACIONES Y TERAPIAS
Entity Type:Organization
Organization Name:CENTRO YAHVEH-RAFA EVALUACIONES Y TERAPIAS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:EDITH
Authorized Official - Middle Name:Y
Authorized Official - Last Name:ROSADO
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:787-485-9803
Mailing Address - Street 1:URB. MONTE ELENA
Mailing Address - Street 2:322 BROMELIA
Mailing Address - City:DORADO
Mailing Address - State:PR
Mailing Address - Zip Code:00646-5616
Mailing Address - Country:US
Mailing Address - Phone:787-485-9803
Mailing Address - Fax:
Practice Address - Street 1:URB MONTE ELENA
Practice Address - Street 2:322 BROMELIA
Practice Address - City:DORADO
Practice Address - State:PR
Practice Address - Zip Code:00646-5616
Practice Address - Country:US
Practice Address - Phone:787-485-9803
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-28
Last Update Date:2011-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1865261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service