Fundacion Modesto Gotay Pro Personas Con Discapacidad Intelectual Y De

NPI #1235580143 in Trujillo Alto, Puerto Rico

Provider Information

NPI Number: 1235580143
Entity Type: Organization
Organization Name: Fundacion Modesto Gotay Pro Personas Con Discapacidad Intelectual Y De
Primary Specialty: Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
Enumeration Date: Jun 22, 2016
Last Updated: Jun 22, 2016

Practice Location

Address: CARR 876 KM 4.6
Address 2: BO. LAS CUEVAS
City: Trujillo Alto
State: Puerto Rico
ZIP Code: 00976-0000
Phone: (787) 761-6244

Authorized Official

Name: MS. NILKA R. ENCARNACION
Title: ADMINISTRATIVE ASSISTANT
Phone: (787) 761-6244

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities	320900000X	Primary

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