Provider Demographics
NPI:1255745725
Name:CENTRO N.J.J .INC
Entity type:Organization
Organization Name:CENTRO N.J.J .INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRADORA
Authorized Official - Prefix:
Authorized Official - First Name:NONISHKA
Authorized Official - Middle Name:
Authorized Official - Last Name:CRUZ MACHADO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-428-2505
Mailing Address - Street 1:D10 CALLE MARGINAL
Mailing Address - Street 2:URB VISTA AZUL
Mailing Address - City:ARECIBO
Mailing Address - State:PR
Mailing Address - Zip Code:00612
Mailing Address - Country:US
Mailing Address - Phone:787-933-6704
Mailing Address - Fax:
Practice Address - Street 1:D10 CALLE MARGINAL
Practice Address - Street 2:URB VISTA AZUL
Practice Address - City:ARECIBO
Practice Address - State:PR
Practice Address - Zip Code:00612
Practice Address - Country:US
Practice Address - Phone:787-428-2505
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-12
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR103TC0700X, 103TH0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TH0004XBehavioral Health & Social Service ProvidersPsychologistHealthGroup - Multi-Specialty
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty