Provider Demographics
NPI:1992950141
Name:CENTRO DE SERVICIOS PSICOEDUCATIVOS DEL OESTE, INC.
Entity type:Organization
Organization Name:CENTRO DE SERVICIOS PSICOEDUCATIVOS DEL OESTE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSUE
Authorized Official - Middle Name:MANUEL
Authorized Official - Last Name:VEGA
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:787-536-0922
Mailing Address - Street 1:763 YAGUEZ
Mailing Address - Street 2:ESTANCIAS DEL RIO
Mailing Address - City:HORMIGUEROS
Mailing Address - State:PR
Mailing Address - Zip Code:00660
Mailing Address - Country:US
Mailing Address - Phone:787-238-2948
Mailing Address - Fax:
Practice Address - Street 1:CARRETAR 2 PLAZA LOS PEREGRINOS
Practice Address - Street 2:
Practice Address - City:HORMIGUEROS
Practice Address - State:PR
Practice Address - Zip Code:00660
Practice Address - Country:US
Practice Address - Phone:787-238-2948
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-01
Last Update Date:2008-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1881261QA0600X, 261QM0855X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health