Basic Information
| Provider Information | |||||||||
| NPI: | 1710640883 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | GUARA BI, INC | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 94738 | ||||||||
| Address2: | |||||||||
| City: | LAS VEGAS | ||||||||
| State: | NV | ||||||||
| PostalCode: | 891934738 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7023852090 | ||||||||
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| Practice Location | |||||||||
| Address1: | CARRETERA 686 BARRIO CABO CARIBE | ||||||||
| Address2: | KILOMETRO 3.7 | ||||||||
| City: | VEGA BAJA | ||||||||
| State: | PR | ||||||||
| PostalCode: | 00693 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7877433960 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 10/15/2021 | ||||||||
| LastUpdateDate: | 11/01/2021 | ||||||||
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| AuthorizedOfficialLastName: | O DUARTE | ||||||||
| AuthorizedOfficialFirstName: | CRISTIAN | ||||||||
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| AuthorizedOfficialTitleorPosition: | CHIEF OPERATIONAL OFFICER | ||||||||
| AuthorizedOfficialTelephone: | 6783827915 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| NPICertificationDate: | 10/15/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QM0801X | N | Ambulatory Health Care Facilities | Clinic/Center | Mental Health (Including Community Mental Health Center) | 251S00000X | Y | Agencies | Community/Behavioral Health |
No ID Information.