Provider Demographics
NPI:1255644563
Name:BAY VIEW BEHAVIORAL CENTER CORP
Entity type:Organization
Organization Name:BAY VIEW BEHAVIORAL CENTER CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYQUIATRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:ROY
Authorized Official - Last Name:VAZQUEZ-MALDONADO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-200-0860
Mailing Address - Street 1:D 54 ZAFIRO
Mailing Address - Street 2:PASEO REAL
Mailing Address - City:DORADO
Mailing Address - State:PR
Mailing Address - Zip Code:00646
Mailing Address - Country:US
Mailing Address - Phone:787-404-1668
Mailing Address - Fax:
Practice Address - Street 1:16 CALLE PRINCIPAL
Practice Address - Street 2:BAY VIEW
Practice Address - City:CATANO
Practice Address - State:PR
Practice Address - Zip Code:00962-4269
Practice Address - Country:US
Practice Address - Phone:787-200-0860
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-16
Last Update Date:2010-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR261QM0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)