Organization
GREISTAR MENTAL AND PHYSICAL HEALTH LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GRISELLE GARCIA HERNANDEZ (PRESIDENT)
(787) 374-5801
Entity
Organization
Contact information
Practice address
75 CALLE LUNA, ESQUINA TORRES, PONCE, PR 00730
(787) 844-5364
Mailing address
PO BOX 336223, PONCE, PR 00733-6223
(787) 844-5364
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
103G00000X
Clinical Neuropsychologist
—
—
103T00000X
Psychologist
—
—
103TB0200X
Cognitive & Behavioral Psychologist
—
—
103TC0700X
Clinical Psychologist
Primary
—
—
103TC2200X
Clinical Child & Adolescent Psychologist
—
—
103TF0000X
Family Psychologist
—
—
103TH0004X
Health Psychologist
—
—
103TH0100X
Health Service Psychologist
—
—
103TP0016X
Prescribing (Medical) Psychologist
—
—
103TP2701X
Group Psychotherapy Psychologist
—
—
103TR0400X
Rehabilitation Psychologist
—
—
104100000X
Social Worker
—
—
106E00000X
Assistant Behavior Analyst
—
—
Other
Enumeration date
12/19/2016
Last updated
05/08/2017
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