# PROGRAMA CUIDADO INTEGRAL DEL SIDA

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

## Provider details

- **NPI number:** 1942641154
- **Authorized official:** MR. JOSE R FELICIANO-SEPULVEDA MHSA (EJECUTIVE DIRECTOR)
- **Authorized official phone:** (787) 852-0768

## Contact information

- **Practice address:** 355 CALLE FONT MARTELO, HUMACAO, PR 00791-3249
- **Practice address phone:** (787) 852-0768
- **Practice address fax:** (787) 656-0735
- **Mailing address:** PO BOX 859, HUMACAO, PR 00792-0859
- **Mailing address phone:** (787) 852-0768
- **Mailing address fax:** (787) 656-0735

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261Q00000X | Clinic/Center | 15F2515 | PR | Yes |

## Other

- **Enumeration date:** 07/16/2013
- **Last updated:** 07/16/2013

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 0436140001 | MEDICARE | PR |