Provider Demographics
NPI:1639317019
Name:CEIP
Entity Type:Organization
Organization Name:CEIP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSICOLOGA
Authorized Official - Prefix:
Authorized Official - First Name:AMARILIS
Authorized Official - Middle Name:
Authorized Official - Last Name:RIVERA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-448-7322
Mailing Address - Street 1:CALLE SAN JOVINO #426
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00926
Mailing Address - Country:US
Mailing Address - Phone:787-747-1374
Mailing Address - Fax:787-745-0549
Practice Address - Street 1:AVE. RAFAEL CORDERO FINAL ESQUINA TROCHE
Practice Address - Street 2:PLAZA DE SALUD SANO
Practice Address - City:CAGUAS
Practice Address - State:PR
Practice Address - Zip Code:00725
Practice Address - Country:US
Practice Address - Phone:787-747-1374
Practice Address - Fax:787-747-0549
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-23
Last Update Date:2009-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR3152103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty