Organization
CENTRO DE SALUD MENTAL DEL OESTE
Active
Other names
CSMDO
Organization subpart
No
Provider details
NPI number
Authorized official
DR. THAIZ RIVERA PHD (PSYCHOLOGIST)
(787) 517-9298
Entity
Organization
Contact information
Practice address
HC 4 BOX 13482, SAN GERMAN, PR 00683-9568
(787) 517-9298
Mailing address
HC 4 BOX 13482, SAN GERMAN, PR 00683-9568
(787) 517-9298
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
PR
261QM0850X
Adult Mental Health Clinic/Center
—
PR
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
PR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1780006155
NPI
PR
01
—
GT591A
PTAN
PR
Enumeration date
06/15/2016
Last updated
06/15/2016
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