| Organization Name: | CENTRO DE SALUD DE LARES, INC. |
| NPI Number: | 1417907502 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | RIGOBERTO HERNANDEZ (EXECUTIVE DIRECTOR) |
| Mailing Address: | Road 111 Km 1.9 Los Patriotas Ave. Lares |
| State: | PR US |
| Postal Code: | 006690379 |
| Phone Number: | 7878972727 |
| Fax Number: | 7878972725 |
| NPI Enumeration Date: | 05/11/2006 |
| NPI Last Update Date: | 04/08/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QF0400X |
| License Number: | CNC99-285 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | PR |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Federally Qualified Health Center (FQHC) |
| Taxonomy Definition: | |