Organization
CORDA OF PR INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GILBERT RODRIGUEZ LHD, DD, TAC III (CEO)
(787) 636-5443
Entity
Organization
Contact information
Practice address
CARR 910 INT KM 4.3 BO CATANO, HUMACAO, PR 00792
(787) 636-4741
(787) 285-1890
Mailing address
PO BOX 220, HUMACAO, PR 00792-0220
(787) 636-4741
(787) 285-1890
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
CTRSA-0243
PR
Other
Enumeration date
04/26/2011
Last updated
04/26/2011
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