Organization Name: | PSYCHCARE SERVICES PR LLC |
NPI Number: | 1326432907 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | THOMAS WALSH (PRESIDENT) |
Mailing Address: | 86 Lakeside Villas # Ab4 Vega Alta |
State: | PR US |
Postal Code: | 006928724 |
Phone Number: | 4076875555 |
Fax Number: | |
NPI Enumeration Date: | 03/23/2015 |
NPI Last Update Date: | 03/23/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TC0700X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: |