Provider Demographics
NPI:1013235761
Name:CENTRO DE SERVICIOS MULTIDISCIPLINARIO EQUILIBRIO INC
Entity Type:Organization
Organization Name:CENTRO DE SERVICIOS MULTIDISCIPLINARIO EQUILIBRIO INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ALICIA
Authorized Official - Middle Name:
Authorized Official - Last Name:CONESA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-746-0100
Mailing Address - Street 1:100 AVE ESPIRITU SANTO
Mailing Address - Street 2:APDO 7204
Mailing Address - City:CAGUAS
Mailing Address - State:PR
Mailing Address - Zip Code:00725-0000
Mailing Address - Country:US
Mailing Address - Phone:787-746-0100
Mailing Address - Fax:787-746-0100
Practice Address - Street 1:AVE. MUNOZ MARIN, URB. VILLA CRIOLLO
Practice Address - Street 2:A - 9
Practice Address - City:CAGUAS
Practice Address - State:PR
Practice Address - Zip Code:00725-0000
Practice Address - Country:US
Practice Address - Phone:787-746-0100
Practice Address - Fax:787-746-0100
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-05
Last Update Date:2012-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No101YS0200XBehavioral Health & Social Service ProvidersCounselorSchoolGroup - Multi-Specialty
No103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounselingGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty