Fundacion Modesto Gotay Pro Personas Con Discapacidad Intelectual Y de

Primary specialty

Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X

License

3 Issued in PR

Legal business name

FUNDACION MODESTO GOTAY PRO PERSONAS CON DISCAPACIDAD INTELECTUAL Y DE

Practice address

Carr 876 KM 4.6
Bo. Las Cuevas
Trujillo Alto, PR 00976-0000

Phone

(787) 761-6244

Fax

(787) 200-4409

NPI assigned

Jun 22, 2016

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ms. Nilka R. Encarnacion

Title

Administrative Assistant

Phone

(787) 761-6244

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1466553600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1466553600000",
    "number": "1235580143",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 665",
            "city": "TRUJILLO ALTO",
            "state": "PR",
            "postal_code": "009770665",
            "telephone_number": "787-761-6244",
            "fax_number": "787-200-4409"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CARR 876 KM 4.6",
            "address_2": "BO. LAS CUEVAS",
            "city": "TRUJILLO ALTO",
            "state": "PR",
            "postal_code": "009760000",
            "telephone_number": "787-761-6244",
            "fax_number": "787-200-4409"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FUNDACION MODESTO GOTAY PRO PERSONAS CON DISCAPACIDAD INTELECTUAL Y DE",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-06-22",
        "last_updated": "2016-06-22",
        "status": "A",
        "authorized_official_last_name": "ENCARNACION",
        "authorized_official_first_name": "NILKA",
        "authorized_official_middle_name": "R.",
        "authorized_official_title_or_position": "ADMINISTRATIVE ASSISTANT",
        "authorized_official_telephone_number": "787-761-6244",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "PR",
            "license": "3",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alfred Arnaldo Freire Sr., MA
• Elimaris Fuentes Tirado, DPT MSPT
• Manuel Fuentes Valentin, RPH
• David Gregorio Fuentes, LPC, LMHC
• Toscania Y. Fulgencio
• Idalia Garcia Cortes, M.D.
• Arturo Garcia Villagomez
• Frances Lynn Garcia-Contreras, MD
• Ethyann Arlene Garcia-Mateo
• Carmelina Cruz Garcia

• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Trujillo Alto, PR
• Providers in Trujillo Alto, PR by specialty
• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Puerto Rico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.