Provider Demographics
NPI:1912525999
Name:CENTRO EMBRACE LIFE, CORP
Entity Type:Organization
Organization Name:CENTRO EMBRACE LIFE, CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:GLORIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:RAMON SANTOS
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:787-359-7106
Mailing Address - Street 1:#22 ESTANCIAS MONTESOL
Mailing Address - Street 2:
Mailing Address - City:GURABO
Mailing Address - State:PR
Mailing Address - Zip Code:00778-0000
Mailing Address - Country:US
Mailing Address - Phone:787-359-7106
Mailing Address - Fax:
Practice Address - Street 1:CALLE ANDRES ARUS RIVERA #55 ALTOS
Practice Address - Street 2:
Practice Address - City:GURABO
Practice Address - State:PR
Practice Address - Zip Code:00778-0000
Practice Address - Country:US
Practice Address - Phone:787-359-7106
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-07
Last Update Date:2020-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounselingGroup - Single Specialty