Provider Demographics
NPI:1598597791
Name:INSIGHT CENTRO PSICOTERAPEUTICO FAMILIAR LLC
Entity type:Organization
Organization Name:INSIGHT CENTRO PSICOTERAPEUTICO FAMILIAR LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:TRABAJADOR SOCIAL
Authorized Official - Prefix:
Authorized Official - First Name:OMAR
Authorized Official - Middle Name:A
Authorized Official - Last Name:FUENTES FLORES
Authorized Official - Suffix:
Authorized Official - Credentials:MSW
Authorized Official - Phone:787-396-6791
Mailing Address - Street 1:PO BOX 65
Mailing Address - Street 2:
Mailing Address - City:SAN SEBASTIAN
Mailing Address - State:PR
Mailing Address - Zip Code:00685
Mailing Address - Country:US
Mailing Address - Phone:787-396-6791
Mailing Address - Fax:
Practice Address - Street 1:#21 CALLE SEVERO ARANA
Practice Address - Street 2:
Practice Address - City:SAN SEBASTIAN
Practice Address - State:PR
Practice Address - Zip Code:00685
Practice Address - Country:US
Practice Address - Phone:787-396-6791
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-15
Last Update Date:2025-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty