Provider Demographics
NPI:1689244121
Name:ADMINISTRACION DE SERVICES DE SALUD MENTAL CONTRA LA ADDICION
Entity Type:Organization
Organization Name:ADMINISTRACION DE SERVICES DE SALUD MENTAL CONTRA LA ADDICION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:AWILDA
Authorized Official - Middle Name:
Authorized Official - Last Name:ALVARADO
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:787-860-0967
Mailing Address - Street 1:148 AVE OSVALDO MOOLINA ESQUINA GENERAL VALERO
Mailing Address - Street 2:
Mailing Address - City:FAJARDO
Mailing Address - State:PR
Mailing Address - Zip Code:00738
Mailing Address - Country:US
Mailing Address - Phone:787-860-0967
Mailing Address - Fax:
Practice Address - Street 1:148 AVE OSVALDO MOOLINA ESQUINA GENERAL VALERO
Practice Address - Street 2:
Practice Address - City:FAJARDO
Practice Address - State:PR
Practice Address - Zip Code:00738
Practice Address - Country:US
Practice Address - Phone:787-860-0967
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ADMINISTRACION DE SERVICES DE SALUD MENTAL CONTRA LA ADDICION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-06-28
Last Update Date:2021-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder