Provider Demographics
NPI:1295048098
Name:COMPREHENSIVE CENTER OF BEHAVIOR AND NEUROSCIENCE INC
Entity type:Organization
Organization Name:COMPREHENSIVE CENTER OF BEHAVIOR AND NEUROSCIENCE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:ANTHONY
Authorized Official - Last Name:AVILES
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:787-725-0985
Mailing Address - Street 1:1605 AVE. PONCE DE LEON SUITE 111
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00909
Mailing Address - Country:US
Mailing Address - Phone:787-725-0985
Mailing Address - Fax:
Practice Address - Street 1:1605 AVE. PONCE DE LEON SUITE 111
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00909
Practice Address - Country:US
Practice Address - Phone:787-725-0985
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-21
Last Update Date:2016-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)