Organization
PROGRAMA DE SERVICIO RESIDENCIAL PARA NINOS Y ADOLESCENTES
Active
Other names
ASSMCA
Organization subpart
No
Provider details
NPI number
Authorized official
JIMMY B'AEZ SALGADO SR. (DIRECTOR DE FACTURACION)
(787) 763-7575
Entity
Organization
Contact information
Practice address
CARR #2 KM 8.2, BAYAMON, PR 00959
(787) 783-0750
(787) 781-8129
Mailing address
PO BOX 607087, BAYAMON, PR 00960-7087
(787) 763-7575
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
10835
PR
163W00000X
Registered Nurse
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
Primary
—
—
323P00000X
Psychiatric Residential Treatment Facility
—
—
364SP0807X
Child & Adolescent Psychiatric/Mental Health Clinical Nurse Specialist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
038813200
—
PR
Enumeration date
06/05/2007
Last updated
07/01/2021
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