Provider Demographics
NPI:1740223973
Name:CONTINUUM MENTAL CARE CORP
Entity Type:Organization
Organization Name:CONTINUUM MENTAL CARE CORP
Other - Org Name:CENTRO CHAI
Other - Org Type:Other Name
Authorized Official - Title/Position:DIRECTOR ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:IVIA
Authorized Official - Middle Name:I
Authorized Official - Last Name:PACHECO COLLADO
Authorized Official - Suffix:
Authorized Official - Credentials:MBA
Authorized Official - Phone:787-860-3558
Mailing Address - Street 1:55 CALLE DEL CARMEN W
Mailing Address - Street 2:
Mailing Address - City:FAJARDO
Mailing Address - State:PR
Mailing Address - Zip Code:00738
Mailing Address - Country:US
Mailing Address - Phone:787-860-3558
Mailing Address - Fax:787-860-7066
Practice Address - Street 1:55 CALLE DEL CARMEN W
Practice Address - Street 2:
Practice Address - City:FAJARDO
Practice Address - State:PR
Practice Address - Zip Code:00738
Practice Address - Country:US
Practice Address - Phone:787-860-3558
Practice Address - Fax:787-860-7066
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CONTINUUM MENTAL CARE CORP
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-06-14
Last Update Date:2024-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR07B2410261QM0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR038127904Medicaid
PR039354800Medicaid
PR038127903Medicaid