Provider Demographics
NPI:1710361837
Name:RESILIENCIAS, INC.
Entity Type:Organization
Organization Name:RESILIENCIAS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:LOURDES
Authorized Official - Middle Name:
Authorized Official - Last Name:MORENO-MARTINEZ
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:787-370-7370
Mailing Address - Street 1:PO BOX 901
Mailing Address - Street 2:
Mailing Address - City:BARCELONETA
Mailing Address - State:PUERTO RICO
Mailing Address - Zip Code:00617
Mailing Address - Country:UM
Mailing Address - Phone:787-242-9994
Mailing Address - Fax:787-846-2688
Practice Address - Street 1:1 URB NUEVA
Practice Address - Street 2:51 URBANIZACION CATALANA
Practice Address - City:BARCELONETA
Practice Address - State:PR
Practice Address - Zip Code:00617-2518
Practice Address - Country:US
Practice Address - Phone:787-242-9994
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-18
Last Update Date:2015-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR3602261QM0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)