| Clinica Gratitud Llc | |
|
Bo Camaseyes Word F112 Calle B 4 Aguadilla PR 00603 | |
| (939) 224-6074 | |
| Not Available |
| Full Name | Clinica Gratitud Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | Bo Camaseyes Word F112 Calle B 4, Aguadilla, Puerto Rico |
| Authorized Official Name and Position | Jackeline Marcial Rios (PRESIDENT) |
| Authorized Official Contact | 7875601254 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Clinica Gratitud Llc 26 Parc Espinal Aguada PR 00602-3165 Ph: (939) 224-6074 | Clinica Gratitud Llc Bo Camaseyes Word F112 Calle B 4 Aguadilla PR 00603 Ph: (939) 224-6074 |
| NPI Number | 1578309332 |
|---|---|
| Provider Enumeration Date | 07/02/2024 |
| Last Update Date | 07/02/2024 |
| Certification Date | 06/24/2024 |
| Medicare PECOS PAC ID | 1850820200 |
|---|---|
| Medicare Enrollment ID | O20250129003325 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1578309332 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Jackeline Marcial Rios |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1932608312 PECOS PAC ID: 3678002029 Enrollment ID: I20250129003337 |
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