1730586967 NPI number — HAPPINESS WELL BEING MENTAL HEALTH

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1730586967 NPI number — HAPPINESS WELL BEING MENTAL HEALTH

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HAPPINESS WELL BEING MENTAL HEALTH
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1730586967
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/03/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 610
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SABANA SECA
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00952-0610
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-448-6007
Provider Business Mailing Address Fax Number:
787-455-8737

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
CARR 167 # 46KM
Provider Second Line Business Practice Location Address:
SUITE 5
Provider Business Practice Location Address City Name:
BAYAMON
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00961-4477
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-448-6007
Provider Business Practice Location Address Fax Number:
787-455-8737
Provider Enumeration Date:
12/03/2014

Additional Information

Authorized Official

Authorized Official Last Name:
CRUZ
Authorized Official First Name:
ABDIEL
Authorized Official Middle Name:
Authorized Official Title or Position:
CLINICAL PSYCHOLOGY
Authorized Official Telephone Number:
787-587-0353

Provider Taxonomy Codes

  • Taxonomy code: 103TC0700X , with the licence number:  3861 , registered in the state of PR ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 1184917601 . This is a "NPI" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".




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