| NPI | 1447479605 |
|---|---|
| Former Legal Business Name | CLINICA DETRATATAMIENTO INTERGRAL ASISTIDO CON MEDICAMENTOS DE PONCE |
| Entity Type | Organization |
| Authorized Contact | JIMMY BAEZ SALGADO Director De Facturacion 787-763-7575 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2800X Clinic/Center, Methadone Clinic |
| Enumeration Date | 2007-04-25 |
| Last Update Date | 2021-09-12 |