Diez, Juventino

Diez, Juventino is an sole proprietor health care provider with primary practice located at 165 Mermaid Ln , Bronx NY 10473-2499. He recently has 4 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), Behavioral Health & Social Service Providers / Mental Health, Behavioral Health & Social Service Providers / Pastoral, Other Service Providers / Peer Specialist. Other Service Providers / Peer Specialist is his primary health care specialty. Diez, Juventino can be contacted via phone (929) 303-0024.

Contact Information

Primary practice address
165 Mermaid Ln Bronx NY 10473-2499
Phone: (929) 303-0024
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X
Behavioral Health & Social Service Providers / Mental Health 101YM0800X
Behavioral Health & Social Service Providers / Pastoral 101YP1600X
Other Service Providers / Peer Specialist 175T00000X New York

Profile Details

NPI number 1053953430
LBN Legal business name Diez, Juventino
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Oct 17th, 2019
Last updated Oct 17th, 2019 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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