Organization
SOCIEDAD DE SALUD MENTAL, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. HIPOLITO B COSTA-PEREZ M.D. (CEO)
(787) 467-1007
Entity
Organization
Contact information
Practice address
118 CARR 159 STE 2B, ORTIZ MEDICAL PLAZA, COROZAL, PR 00783-2346
(787) 859-4973
(787) 859-5152
Mailing address
PO BOX 367631, SAN JUAN, PR 00936-7631
(787) 859-4973
(787) 859-5152
Taxonomy
Speciality
Code
Description
License number
State
302F00000X
Exclusive Provider Organization
Primary
—
—
Other
Enumeration date
10/01/2014
Last updated
10/01/2014
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