Provider Demographics
NPI:1386449205
Name:COMUNIDAD VIVA INC
Entity type:Organization
Organization Name:COMUNIDAD VIVA INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MARISOL
Authorized Official - Middle Name:
Authorized Official - Last Name:LUNA
Authorized Official - Suffix:
Authorized Official - Credentials:CCMC
Authorized Official - Phone:787-462-1101
Mailing Address - Street 1:WILLIAM FUERTES 73B CALLE 3
Mailing Address - Street 2:
Mailing Address - City:CATANO
Mailing Address - State:PR
Mailing Address - Zip Code:00962-5807
Mailing Address - Country:US
Mailing Address - Phone:787-462-1101
Mailing Address - Fax:
Practice Address - Street 1:WILLIAM FUERTES
Practice Address - Street 2:76 CALLE 2
Practice Address - City:CATANO
Practice Address - State:PR
Practice Address - Zip Code:00962-5807
Practice Address - Country:US
Practice Address - Phone:787-462-1101
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-02-14
Last Update Date:2025-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty