Provider Demographics
NPI:1982852604
Name:MMC PLUS, INC.
Entity Type:Organization
Organization Name:MMC PLUS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE-PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:EFRAIN
Authorized Official - Middle Name:SOTO
Authorized Official - Last Name:VEGA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-633-8077
Mailing Address - Street 1:PO BOX 801081
Mailing Address - Street 2:COTTO LAUREL
Mailing Address - City:PONCE
Mailing Address - State:PR
Mailing Address - Zip Code:00780-1081
Mailing Address - Country:US
Mailing Address - Phone:787-633-8077
Mailing Address - Fax:787-844-0594
Practice Address - Street 1:AVENIDA HOSTOS # 410
Practice Address - Street 2:BO. SABALOS
Practice Address - City:MAYAGUEZ
Practice Address - State:PR
Practice Address - Zip Code:00680-1081
Practice Address - Country:US
Practice Address - Phone:787-633-8077
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-05
Last Update Date:2009-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PRN/A261QM0850X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health