# SUBSTANCE ABUSE AND MENTAL HEALTH SERVICES ADMINISTRATION

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1770786410
- **Authorized official:** MISS CARMEN B AVINO RN (GENERAL NURSE SUPERVISOR)
- **Authorized official phone:** 17877863620

## Contact information

- **Practice address:** AVE LAUREL SANTA JUANITA, HOSP DR RAMON RUIZ ARNAU, BAYAMON, PR 00920-3860
- **Practice address phone:** (178) 778-6362
- **Practice address fax:** (787) 781-8129
- **Mailing address:** CALLE EMANUELLI, 205 APT.1, SAN JUAN, PR 00917-4100
- **Mailing address phone:** (787) 783-0750
- **Mailing address fax:** (787) 781-8129

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 322D00000X | Emotionally Disturbed Childrens' Residential Treatment Facility | 15500 | PR | Yes |

## Other

- **Enumeration date:** 06/08/2007
- **Last updated:** 09/30/2008