| NPI | 1235508243 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSE LUIS REYES Waiver Support COO Rdinator 787-221-2198 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization |
| Enumeration Date | 2015-09-20 |
| Last Update Date | 2015-09-20 |