Provider Demographics
NPI:1447503404
Name:INSTITUTE FOR INDIVIDUAL, GROUP AND ORGANIZATIONAL DEVELOPMENT, INC.
Entity type:Organization
Organization Name:INSTITUTE FOR INDIVIDUAL, GROUP AND ORGANIZATIONAL DEVELOPMENT, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTORA EJECUTIVA
Authorized Official - Prefix:MRS
Authorized Official - First Name:GLORIA
Authorized Official - Middle Name:M
Authorized Official - Last Name:MOLINA
Authorized Official - Suffix:
Authorized Official - Credentials:MSW
Authorized Official - Phone:787-737-7636
Mailing Address - Street 1:PO BOX 1348
Mailing Address - Street 2:
Mailing Address - City:GURABO
Mailing Address - State:PR
Mailing Address - Zip Code:00778-1348
Mailing Address - Country:US
Mailing Address - Phone:787-737-7636
Mailing Address - Fax:787-737-7636
Practice Address - Street 1:53 CALLE SANTIAGO N
Practice Address - Street 2:
Practice Address - City:GURABO
Practice Address - State:PR
Practice Address - Zip Code:00778-2438
Practice Address - Country:US
Practice Address - Phone:787-737-7636
Practice Address - Fax:787-737-7636
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-16
Last Update Date:2016-05-17
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