Provider Demographics
NPI:1740988492
Name:INTEGRAL THERAPY CENTER-MANATI, LLC.
Entity type:Organization
Organization Name:INTEGRAL THERAPY CENTER-MANATI, LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ABDIEL
Authorized Official - Middle Name:WILFREDO
Authorized Official - Last Name:GALAN RIVERA
Authorized Official - Suffix:
Authorized Official - Credentials:MBA
Authorized Official - Phone:787-685-6835
Mailing Address - Street 1:URB. LOS PINOS 1
Mailing Address - Street 2:177 CALLE JUNIPERO SAVINA
Mailing Address - City:ARECIBO
Mailing Address - State:PR
Mailing Address - Zip Code:00612
Mailing Address - Country:US
Mailing Address - Phone:787-685-6835
Mailing Address - Fax:
Practice Address - Street 1:URB. FLAMBOYAN, D15 CALLE MCKINLEY
Practice Address - Street 2:EDIFICIO OHARRIZ, SUITE 4
Practice Address - City:MANATI
Practice Address - State:PR
Practice Address - Zip Code:00674
Practice Address - Country:US
Practice Address - Phone:787-308-0508
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-22
Last Update Date:2023-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty