Provider Demographics
NPI:1366310120
Name:LAND OF FREEDOM PUERTO RICO INC.
Entity type:Organization
Organization Name:LAND OF FREEDOM PUERTO RICO INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROGRAM DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JOEL
Authorized Official - Middle Name:JOSE
Authorized Official - Last Name:SEDA OLMO
Authorized Official - Suffix:
Authorized Official - Credentials:ADICTION CONSULER
Authorized Official - Phone:787-831-7649
Mailing Address - Street 1:PO BOX 6206
Mailing Address - Street 2:
Mailing Address - City:MAYAGUEZ
Mailing Address - State:PR
Mailing Address - Zip Code:00681-6206
Mailing Address - Country:US
Mailing Address - Phone:787-831-7649
Mailing Address - Fax:
Practice Address - Street 1:CARR 111 KM 24.0 INT. 450
Practice Address - Street 2:
Practice Address - City:SAN SEBASTION
Practice Address - State:PR
Practice Address - Zip Code:00685
Practice Address - Country:US
Practice Address - Phone:787-831-7649
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-10-24
Last Update Date:2025-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder