# PROGRAMA DE SERVICIO RESIDENCIAL PARA NINOS Y ADOLESCENTES

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- **Entity:** Organization
- **Status:** Active
- **Other names:** ASSMCA
- **Organization subpart:** No

## Provider details

- **NPI number:** 1487856902
- **Authorized official:** JIMMY B'AEZ SALGADO SR. (DIRECTOR DE FACTURACION)
- **Authorized official phone:** (787) 763-7575

## Contact information

- **Practice address:** CARR \#2 KM 8.2, BAYAMON, PR 00959
- **Practice address phone:** (787) 783-0750
- **Practice address fax:** (787) 781-8129
- **Mailing address:** PO BOX 607087, BAYAMON, PR 00960-7087
- **Mailing address phone:** (787) 763-7575

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 163W00000X | Registered Nurse | 10835 | PR | — |
| 163W00000X | Registered Nurse | — | NULL | — |
| 163W00000X | Registered Nurse | — | — | — |
| 261QM0855X | Adolescent and Children Mental Health Clinic/Center | — | NULL | Yes |
| 323P00000X | Psychiatric Residential Treatment Facility | — | NULL | — |
| 364SP0807X | Child & Adolescent Psychiatric/Mental Health Clinical Nurse Specialist | — | NULL | — |
| 364SP0807X | Child & Adolescent Psychiatric/Mental Health Clinical Nurse Specialist | — | — | — |

## Other

- **Enumeration date:** 06/05/2007
- **Last updated:** 07/01/2021