Organization
TEEN CHALLENGE DE PUERTO RICO, INC.
Active
Other names
TEEN CHALLENGE DETOX
Organization subpart
No
Provider details
NPI number
Authorized official
OLGA J GOMEZ RIVERA PMB (BILLER)
(787) 632-2072
Entity
Organization
Contact information
Practice address
CARRETERA #2 KM 7.7, BAYAMON, PR 00958-4273
(787) 730-6908
Mailing address
PO BOX 4273, BAYAMON, PR 00958-1273
(787) 730-6908
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
39129800
—
PR
Enumeration date
10/16/2020
Last updated
03/24/2025
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