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Organization
GOTHAM
Active
Organization
GOTHAM
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CARLOS VALDEZ (DIRECTOR)
(787) 550-5316
Entity
Organization
Contact information
Practice address
220 CALLE MANUEL DOMENECH, SAN JUAN, PR 00918-3533
(787) 567-1286
Mailing address
220 CALLE MANUEL DOMENECH, SAN JUAN, PR 00918-3533
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
07/20/2017
Last updated
12/09/2020
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