Provider Demographics
NPI:1548807951
Name:COSTA SALUD COMMUNITY HEALTH CENTERS, INC
Entity type:Organization
Organization Name:COSTA SALUD COMMUNITY HEALTH CENTERS, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:M
Authorized Official - Last Name:QUINONES TORRES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-823-5500
Mailing Address - Street 1:PO BOX 638
Mailing Address - Street 2:
Mailing Address - City:RINCON
Mailing Address - State:PR
Mailing Address - Zip Code:00677-0638
Mailing Address - Country:US
Mailing Address - Phone:787-823-5500
Mailing Address - Fax:787-823-3314
Practice Address - Street 1:124 CALAZAN LASALLE
Practice Address - Street 2:
Practice Address - City:MOCA
Practice Address - State:PR
Practice Address - Zip Code:00676
Practice Address - Country:US
Practice Address - Phone:787-823-5500
Practice Address - Fax:787-823-3314
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-12-04
Last Update Date:2025-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)
No261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity Health