Provider Demographics
NPI:1871316893
Name:CENTRO DE RENOVACION INTEGRAL LLC
Entity type:Organization
Organization Name:CENTRO DE RENOVACION INTEGRAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JULIO
Authorized Official - Middle Name:A
Authorized Official - Last Name:ADORNO FELICIANO
Authorized Official - Suffix:
Authorized Official - Credentials:LCDO
Authorized Official - Phone:939-200-7103
Mailing Address - Street 1:URB PASEOS REALES 251 CALLE SEGOBIA
Mailing Address - Street 2:
Mailing Address - City:AGUADILLA
Mailing Address - State:PR
Mailing Address - Zip Code:00603
Mailing Address - Country:US
Mailing Address - Phone:939-200-7103
Mailing Address - Fax:
Practice Address - Street 1:AVENIDA AGUSTIN RAMOS CALERO INTERIOR
Practice Address - Street 2:CARR 112 KM 1.4
Practice Address - City:ISABELA
Practice Address - State:PR
Practice Address - Zip Code:00662-0737
Practice Address - Country:US
Practice Address - Phone:939-200-7103
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-07
Last Update Date:2024-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty