Provider Demographics
NPI:1457783706
Name:CABO ROJO PSYCHOLOGY SERVICES-PARA EL BIENESTAR FAMILIAR, INC.
Entity type:Organization
Organization Name:CABO ROJO PSYCHOLOGY SERVICES-PARA EL BIENESTAR FAMILIAR, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CLINICAL PSYCHOLOGIST DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:YESENIA
Authorized Official - Middle Name:
Authorized Official - Last Name:GARCIA VELEZ
Authorized Official - Suffix:
Authorized Official - Credentials:PSY D
Authorized Official - Phone:787-464-3162
Mailing Address - Street 1:57 CALLE MUNOZ RIVERA
Mailing Address - Street 2:
Mailing Address - City:CABO ROJO
Mailing Address - State:PR
Mailing Address - Zip Code:00623-4041
Mailing Address - Country:US
Mailing Address - Phone:787-464-3162
Mailing Address - Fax:
Practice Address - Street 1:57 CALLE MUNOZ RIVERA
Practice Address - Street 2:
Practice Address - City:CABO ROJO
Practice Address - State:PR
Practice Address - Zip Code:00623-4041
Practice Address - Country:US
Practice Address - Phone:787-464-3162
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-08
Last Update Date:2013-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR2653261QM0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)