Provider Demographics
NPI:1841542420
Name:ASSMCA
Entity type:Organization
Organization Name:ASSMCA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOCIAL WORKER
Authorized Official - Prefix:MRS
Authorized Official - First Name:CLARIBEL
Authorized Official - Middle Name:
Authorized Official - Last Name:ZAMBRANA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-284-1205
Mailing Address - Street 1:HC 3 BOX 11738
Mailing Address - Street 2:
Mailing Address - City:JUANA DIAZ
Mailing Address - State:PR
Mailing Address - Zip Code:00795-9570
Mailing Address - Country:US
Mailing Address - Phone:787-284-1240
Mailing Address - Fax:787-840-8039
Practice Address - Street 1:BO. COLLORES CARR. 512 KM. 5.2
Practice Address - Street 2:
Practice Address - City:JUANA DIAZ
Practice Address - State:PR
Practice Address - Zip Code:00795
Practice Address - Country:US
Practice Address - Phone:787-284-1240
Practice Address - Fax:787-840-8039
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-08
Last Update Date:2012-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR10510261QR0405X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder