Provider Demographics
NPI:1992687479
Name:CLINICA MULTIDISCIPLINARIA DE LA MONTANA LLC
Entity type:Organization
Organization Name:CLINICA MULTIDISCIPLINARIA DE LA MONTANA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSICOLOGA CLINICA
Authorized Official - Prefix:
Authorized Official - First Name:ROSA
Authorized Official - Middle Name:WALKIRIA
Authorized Official - Last Name:RIVERA
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:787-481-1599
Mailing Address - Street 1:12 AVE ROLANDO CABANAS VALLS
Mailing Address - Street 2:
Mailing Address - City:UTUADO
Mailing Address - State:PR
Mailing Address - Zip Code:00641-2491
Mailing Address - Country:US
Mailing Address - Phone:787-481-1599
Mailing Address - Fax:
Practice Address - Street 1:10 AVE ESTEVES
Practice Address - Street 2:
Practice Address - City:UTUADO
Practice Address - State:PR
Practice Address - Zip Code:00641-3025
Practice Address - Country:US
Practice Address - Phone:787-481-1599
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-07-24
Last Update Date:2025-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)