Provider Demographics
NPI:1689249609
Name:DLIS WELLNESS SALUD MENTAL
Entity Type:Organization
Organization Name:DLIS WELLNESS SALUD MENTAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:DAMARIS
Authorized Official - Middle Name:
Authorized Official - Last Name:CORTES-FIGUEROA
Authorized Official - Suffix:
Authorized Official - Credentials:LCMHC
Authorized Official - Phone:828-489-7002
Mailing Address - Street 1:PARK GARDENS CALLE GETTYSBURG T10
Mailing Address - Street 2:
Mailing Address - City:SAN JAN
Mailing Address - State:PR
Mailing Address - Zip Code:00926-2157
Mailing Address - Country:US
Mailing Address - Phone:828-489-7002
Mailing Address - Fax:828-595-2716
Practice Address - Street 1:PARK GARDENS CALLE GETTYSBURG T10
Practice Address - Street 2:
Practice Address - City:SAN JAN
Practice Address - State:PR
Practice Address - Zip Code:00926-2157
Practice Address - Country:US
Practice Address - Phone:828-489-7002
Practice Address - Fax:828-595-2716
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-21
Last Update Date:2021-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)