| Transforma Family Group Therapy Llc | |
|
Jose Vicente Street 606 Penuelas PR 00624 | |
| (939) 248-2152 | |
| Not Available |
| Full Name | Transforma Family Group Therapy Llc |
|---|---|
| Speciality | Psychologist |
| Location | Jose Vicente Street 606, Penuelas, Puerto Rico |
| Authorized Official Name and Position | Eunice Santiago Maldonado (PRESIDENT) |
| Authorized Official Contact | 9392482152 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Transforma Family Group Therapy Llc Calle Jose Vicente #606 Penuelas PR 00624 Ph: (939) 992-9233 | Transforma Family Group Therapy Llc Jose Vicente Street 606 Penuelas PR 00624 Ph: (939) 248-2152 |
| NPI Number | 1528727898 |
|---|---|
| Provider Enumeration Date | 12/14/2021 |
| Last Update Date | 06/28/2023 |
| Certification Date | 06/14/2023 |
| Medicare PECOS PAC ID | 6608239967 |
|---|---|
| Medicare Enrollment ID | O20230905000731 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1528727898 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | (* (Not Available)) | Primary |
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Secondary |
| Provider Name | Eunice Santiago Maldonado |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1063721116 PECOS PAC ID: 8022417856 Enrollment ID: I20230905000853 |
| Provider Name | Mary Liz Baez Rodriguez |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1750159240 PECOS PAC ID: 6103277751 Enrollment ID: I20240108004214 |