Provider Demographics
NPI:1649937947
Name:RIVERA EMOTIONAL HEALTH CENTER, LLC
Entity type:Organization
Organization Name:RIVERA EMOTIONAL HEALTH CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MAILY
Authorized Official - Middle Name:
Authorized Official - Last Name:RIVERA-MALDONADO
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:787-967-1467
Mailing Address - Street 1:400 AVE DOMENECH STE 509
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00918-3705
Mailing Address - Country:US
Mailing Address - Phone:787-998-1297
Mailing Address - Fax:
Practice Address - Street 1:400 AVE DOMENECH STE 509
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00918-3705
Practice Address - Country:US
Practice Address - Phone:787-998-1297
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-21
Last Update Date:2021-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty