Organization
PRIME SUPPORT GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STEVEN DALMAU (PRESIDENT)
(787) 769-2369
Entity
Organization
Contact information
Practice address
99 CALLE BLOQUE 89 - 1, URB. VILLA CAROLINA, CAROLINA, PR 00985
(787) 360-1859
Mailing address
99 CALLE BLOQUE 89 - 1, URB. VILLA CAROLINA, CAROLINA, PR 00985
(787) 769-2369
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
—
—
1041C0700X
Clinical Social Worker
—
—
2084P0800X
Psychiatry Physician
—
—
Other
Enumeration date
04/13/2016
Last updated
09/28/2020
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