Provider Demographics
NPI:1790242337
Name:CENTRO DE BALANCE EMOCIONAL LLC
Entity Type:Organization
Organization Name:CENTRO DE BALANCE EMOCIONAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MINEIRA
Authorized Official - Middle Name:I
Authorized Official - Last Name:SERRANO MORALES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-920-1310
Mailing Address - Street 1:HC 6 BOX 133040
Mailing Address - Street 2:
Mailing Address - City:SAN SEBASTIAN
Mailing Address - State:PR
Mailing Address - Zip Code:00685-6306
Mailing Address - Country:US
Mailing Address - Phone:787-920-1310
Mailing Address - Fax:
Practice Address - Street 1:67 CALLE PAVIA FERNANDEZ
Practice Address - Street 2:
Practice Address - City:SAN SEBASTIAN
Practice Address - State:PR
Practice Address - Zip Code:00685-2207
Practice Address - Country:US
Practice Address - Phone:787-920-1310
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-01
Last Update Date:2022-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty