Provider Demographics
NPI:1801652821
Name:NEUROCARE PSYCHOLOGY SERVICES LLC
Entity type:Organization
Organization Name:NEUROCARE PSYCHOLOGY SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JUAN
Authorized Official - Middle Name:M
Authorized Official - Last Name:SALAS VAZQUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:939-905-6420
Mailing Address - Street 1:HC 2 BOX 21265
Mailing Address - Street 2:
Mailing Address - City:SAN SEBASTIAN
Mailing Address - State:PR
Mailing Address - Zip Code:00685-9219
Mailing Address - Country:US
Mailing Address - Phone:787-996-3920
Mailing Address - Fax:
Practice Address - Street 1:CENTRO INTERNATIONAL DE MERCADEO
Practice Address - Street 2:90 CARR 165 TORRE 2 SUITE 302
Practice Address - City:GUAYNABO
Practice Address - State:PR
Practice Address - Zip Code:00968-8063
Practice Address - Country:US
Practice Address - Phone:939-905-6420
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-27
Last Update Date:2024-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty