Provider Demographics
NPI:1669919866
Name:SERVICIOS PARA MEJORAR LA SALUD MENTAL
Entity type:Organization
Organization Name:SERVICIOS PARA MEJORAR LA SALUD MENTAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL PSYCHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:MARCELLE
Authorized Official - Middle Name:E
Authorized Official - Last Name:CRUZ PAGAN
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:787-354-2088
Mailing Address - Street 1:HC 4 BOX 12559
Mailing Address - Street 2:
Mailing Address - City:RIO GRANDE
Mailing Address - State:PR
Mailing Address - Zip Code:00745-9458
Mailing Address - Country:US
Mailing Address - Phone:787-354-2088
Mailing Address - Fax:
Practice Address - Street 1:B16 CALLE 2
Practice Address - Street 2:URB BRISAS DEL MAR
Practice Address - City:LUQUILLO
Practice Address - State:PR
Practice Address - Zip Code:00773
Practice Address - Country:US
Practice Address - Phone:787-354-2088
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-25
Last Update Date:2017-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR3525261QM0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)