Provider Demographics
NPI:1295563955
Name:CLINICA DE SERVICIOS INTEGRADOSN ETAPAS LLC
Entity type:Organization
Organization Name:CLINICA DE SERVICIOS INTEGRADOSN ETAPAS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:TRABAJADORA SOCIAL CLINICA
Authorized Official - Prefix:MRS
Authorized Official - First Name:ELENA
Authorized Official - Middle Name:CUEVAS
Authorized Official - Last Name:MONTERO
Authorized Official - Suffix:
Authorized Official - Credentials:MSW
Authorized Official - Phone:787-202-0616
Mailing Address - Street 1:HC 4 BOX 10014
Mailing Address - Street 2:
Mailing Address - City:UTUADO
Mailing Address - State:PR
Mailing Address - Zip Code:00641-7901
Mailing Address - Country:US
Mailing Address - Phone:787-397-7387
Mailing Address - Fax:
Practice Address - Street 1:CARRETERA 123 K. 54.6 INTERIOR
Practice Address - Street 2:BARRIO SALTO ARRIBA, UTUADO
Practice Address - City:UTUADO
Practice Address - State:PR
Practice Address - Zip Code:00641
Practice Address - Country:US
Practice Address - Phone:787-397-7387
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-24
Last Update Date:2024-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty