Provider Demographics
NPI:1215327895
Name:CLINICA DE TERAPIA HORIZONTE LLC
Entity type:Organization
Organization Name:CLINICA DE TERAPIA HORIZONTE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:BELMAR
Authorized Official - Middle Name:
Authorized Official - Last Name:RIVERA
Authorized Official - Suffix:
Authorized Official - Credentials:MS SLP
Authorized Official - Phone:787-783-3800
Mailing Address - Street 1:1262 AVE AMERICO MIRANDA
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00921-1620
Mailing Address - Country:US
Mailing Address - Phone:787-783-3800
Mailing Address - Fax:
Practice Address - Street 1:1262 AVE AMERICO MIRANDA
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00921-1620
Practice Address - Country:US
Practice Address - Phone:787-783-3800
Practice Address - Fax:787-783-3800
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-03
Last Update Date:2015-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR788103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty