Provider Demographics
NPI:1730494899
Name:CENTRO DE TERAPIA AMOR
Entity Type:Organization
Organization Name:CENTRO DE TERAPIA AMOR
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OCUPATIONAL THERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARIBEL
Authorized Official - Middle Name:
Authorized Official - Last Name:DE JESUS
Authorized Official - Suffix:
Authorized Official - Credentials:OTL
Authorized Official - Phone:787-259-3398
Mailing Address - Street 1:BO. PLAYA AVE. HOSTOS # 940
Mailing Address - Street 2:
Mailing Address - City:PONCE
Mailing Address - State:PR
Mailing Address - Zip Code:00716-0305
Mailing Address - Country:US
Mailing Address - Phone:787-259-3398
Mailing Address - Fax:787-812-4818
Practice Address - Street 1:AVE. HOSTOS BO.PLAYA
Practice Address - Street 2:940
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00716-1113
Practice Address - Country:US
Practice Address - Phone:787-259-3398
Practice Address - Fax:787-812-4818
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-13
Last Update Date:2014-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR487251C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services