Provider Demographics
NPI:1821209826
Name:CENTRO DE SALUD MENTAL, INC
Entity Type:Organization
Organization Name:CENTRO DE SALUD MENTAL, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ASISTENTE ADMINISTRATIVO
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:
Authorized Official - Last Name:MOJICA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-276-8763
Mailing Address - Street 1:PISO 6, CAROLINA SHOPPING COURT
Mailing Address - Street 2:SUITE # 311
Mailing Address - City:CAROLINA
Mailing Address - State:PR
Mailing Address - Zip Code:00986
Mailing Address - Country:US
Mailing Address - Phone:787-276-8763
Mailing Address - Fax:787-276-8763
Practice Address - Street 1:PISO 6, CAROLINA SHOPPING COURT
Practice Address - Street 2:SUITE # 311
Practice Address - City:CAROLINA
Practice Address - State:PR
Practice Address - Zip Code:00986
Practice Address - Country:US
Practice Address - Phone:787-276-8763
Practice Address - Fax:787-276-8763
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-24
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR16242302R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization