Provider Demographics
NPI:1902083504
Name:CENTRO DE MEJORAMIENTO EMOCIONAL CME
Entity Type:Organization
Organization Name:CENTRO DE MEJORAMIENTO EMOCIONAL CME
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:GUSTAVO
Authorized Official - Middle Name:R
Authorized Official - Last Name:HALLEY
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:787-891-8664
Mailing Address - Street 1:PO BOX 5027
Mailing Address - Street 2:
Mailing Address - City:AGUADILLA
Mailing Address - State:PR
Mailing Address - Zip Code:00605-5027
Mailing Address - Country:US
Mailing Address - Phone:787-891-8664
Mailing Address - Fax:
Practice Address - Street 1:STATE ROAD #2 KM 124.2
Practice Address - Street 2:
Practice Address - City:AGUADILLA
Practice Address - State:PR
Practice Address - Zip Code:00603
Practice Address - Country:US
Practice Address - Phone:787-891-8664
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-25
Last Update Date:2008-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR2002103TC0700X
PR2610103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty