Provider Demographics
NPI:1881939551
Name:FUNDACION U.P.E.N.S., INC.
Entity type:Organization
Organization Name:FUNDACION U.P.E.N.S., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL SERVICES CORDINATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:WANDA
Authorized Official - Middle Name:I
Authorized Official - Last Name:MIRANDA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-883-3345
Mailing Address - Street 1:PO BOX 4157
Mailing Address - Street 2:
Mailing Address - City:VEGA BAJA
Mailing Address - State:PR
Mailing Address - Zip Code:00694-4157
Mailing Address - Country:US
Mailing Address - Phone:787-883-3345
Mailing Address - Fax:787-883-3348
Practice Address - Street 1:CALLE LUIS MUNOZ RIVERA SOLAR A
Practice Address - Street 2:
Practice Address - City:VEGA ALTA
Practice Address - State:PR
Practice Address - Zip Code:00692
Practice Address - Country:US
Practice Address - Phone:787-883-3345
Practice Address - Fax:787-883-3348
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-12-06
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR324500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility