Organization
SUBSTANCE ABUSE AND MENTAL HEALTH SERVICES ADMINISTRATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS CARMEN B AVINO RN (GENERAL NURSE SUPERVISOR)
17877863620
Entity
Organization
Contact information
Practice address
AVE LAUREL SANTA JUANITA, HOSP DR RAMON RUIZ ARNAU, BAYAMON, PR 00920-3860
(178) 778-6362
(787) 781-8129
Mailing address
CALLE EMANUELLI, 205 APT.1, SAN JUAN, PR 00917-4100
(787) 783-0750
(787) 781-8129
Taxonomy
Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
15500
PR
Other
Enumeration date
06/08/2007
Last updated
09/30/2008
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