Provider Demographics
NPI:1124776158
Name:SERVICIOS INTEGRALES DE SALUD EMOCIONAL SISE CSP
Entity type:Organization
Organization Name:SERVICIOS INTEGRALES DE SALUD EMOCIONAL SISE CSP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LYDIA
Authorized Official - Middle Name:Z
Authorized Official - Last Name:RODRIGUEZ RIOS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:939-276-2432
Mailing Address - Street 1:HC 01 BOX 2381
Mailing Address - Street 2:
Mailing Address - City:MOROVIS
Mailing Address - State:PR
Mailing Address - Zip Code:00687-8251
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:CARR. 155 KM 55.9 BO FRANQUEZ
Practice Address - Street 2:
Practice Address - City:MOROVIS
Practice Address - State:PR
Practice Address - Zip Code:00687
Practice Address - Country:US
Practice Address - Phone:939-276-2432
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-18
Last Update Date:2023-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center