Provider Demographics
NPI:1356900468
Name:SMART THERAPY CENTER
Entity type:Organization
Organization Name:SMART THERAPY CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENTE
Authorized Official - Prefix:MISS
Authorized Official - First Name:IVONNE
Authorized Official - Middle Name:M
Authorized Official - Last Name:ORTIZ MORALES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-248-9335
Mailing Address - Street 1:PO BOX 529
Mailing Address - Street 2:
Mailing Address - City:COROZAL
Mailing Address - State:PR
Mailing Address - Zip Code:00783-0529
Mailing Address - Country:US
Mailing Address - Phone:787-248-9335
Mailing Address - Fax:
Practice Address - Street 1:CARRETERA 802 SECTOR ROLO PACHECO
Practice Address - Street 2:
Practice Address - City:COROZAL
Practice Address - State:PR
Practice Address - Zip Code:00783-0529
Practice Address - Country:US
Practice Address - Phone:787-248-9335
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-12
Last Update Date:2019-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & AdolescentGroup - Multi-Specialty
No261QC1800XAmbulatory Health Care FacilitiesClinic/CenterCorporate HealthGroup - Multi-Specialty
No261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service