Organization
PSIDEP LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ABDIEL MUNIZ VERA DR (DIRECTOR)
(787) 546-7508
Entity
Organization
Contact information
Practice address
MOCA MEDICAL PLAZA #113 CARR 110 KM 12.4, MOCA, PR 00676
(787) 546-7508
Mailing address
PO BOX 1106, MOCA, PR 00676-1106
(787) 546-7508
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
Other
Enumeration date
06/07/2022
Last updated
06/07/2022
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