Provider Demographics
NPI:1245437946
Name:CORRECTIONAL HEALTH SERVICES CORPORATION
Entity type:Organization
Organization Name:CORRECTIONAL HEALTH SERVICES CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL SERVICES DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:YANIRA
Authorized Official - Middle Name:IVONNE
Authorized Official - Last Name:PEREZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-774-3344
Mailing Address - Street 1:PO BOX 859
Mailing Address - Street 2:
Mailing Address - City:QUEBRADILLAS
Mailing Address - State:PR
Mailing Address - Zip Code:00678-0859
Mailing Address - Country:US
Mailing Address - Phone:787-895-5345
Mailing Address - Fax:
Practice Address - Street 1:18 CALLE 1
Practice Address - Street 2:SUITE 400 METRO OFFICE PARK
Practice Address - City:GUAYNABO
Practice Address - State:PR
Practice Address - Zip Code:00968-1768
Practice Address - Country:US
Practice Address - Phone:787-774-3344
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR10180261QP2400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2400XAmbulatory Health Care FacilitiesClinic/CenterPrison Health