| Organization Name: | COSTA SALUD COMMUNITY HEALTH CENTER |
| NPI Number: | 1063715472 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | SUSANA M PEREZ (EXECUTIVE DIRECTOR) |
| Mailing Address: | 28 Calle Munoz Rivera W Rincon |
| State: | PR US |
| Postal Code: | 006772127 |
| Phone Number: | 7878235555 |
| Fax Number: | 7878232990 |
| NPI Enumeration Date: | 12/08/2010 |
| NPI Last Update Date: | 09/10/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QR0200X |
| License Number: | 56 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | PR |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Radiology |
| Taxonomy Definition: | |