Provider Demographics
NPI:1972843209
Name:CARE TRANSITION PROGRAM BM, CORP
Entity Type:Organization
Organization Name:CARE TRANSITION PROGRAM BM, CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:YAMILET
Authorized Official - Middle Name:
Authorized Official - Last Name:LOPEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MBA
Authorized Official - Phone:787-562-5168
Mailing Address - Street 1:1519 AVE PONCE DE LEON
Mailing Address - Street 2:SUITE 1219
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00909-1703
Mailing Address - Country:US
Mailing Address - Phone:787-562-5168
Mailing Address - Fax:787-722-2374
Practice Address - Street 1:1519 AVE PONCE DE LEON
Practice Address - Street 2:SUITE 1219
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00909-1703
Practice Address - Country:US
Practice Address - Phone:787-562-5168
Practice Address - Fax:787-722-2374
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-23
Last Update Date:2013-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302F00000XManaged Care OrganizationsExclusive Provider Organization
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR322163OtherREGISTRO