| Organization Name: | INTEGRATED MENTAL HEALTH GROUP |
| NPI Number: | 1063803187 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | GERARDO R RIVERA (PRESIDENTE) |
| Mailing Address: | Carretera 693 Km 13.8 Edificio Brisas Del Mar Bo Sabana Vega Alta |
| State: | PR US |
| Postal Code: | 00692 |
| Phone Number: | 7876040186 |
| Fax Number: | |
| NPI Enumeration Date: | 02/11/2015 |
| NPI Last Update Date: | 02/11/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC0700X |
| License Number: | 2797 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | PR |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | |