Provider Demographics
NPI:1205228343
Name:LEARN & GROW THERAPY GROUP LLC
Entity Type:Organization
Organization Name:LEARN & GROW THERAPY GROUP LLC
Other - Org Name:CLINICA TERAPEUTICA
Other - Org Type:Other Name
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:IRELIS
Authorized Official - Middle Name:
Authorized Official - Last Name:PEREZ
Authorized Official - Suffix:
Authorized Official - Credentials:PHL
Authorized Official - Phone:787-462-9480
Mailing Address - Street 1:PO BOX 2020
Mailing Address - Street 2:PMB 288
Mailing Address - City:BARCELONETA
Mailing Address - State:PR
Mailing Address - Zip Code:00617-2020
Mailing Address - Country:US
Mailing Address - Phone:787-462-9480
Mailing Address - Fax:
Practice Address - Street 1:66 URB CATALANA
Practice Address - Street 2:
Practice Address - City:BARCELONETA
Practice Address - State:PR
Practice Address - Zip Code:00617-2725
Practice Address - Country:US
Practice Address - Phone:787-462-9480
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-26
Last Update Date:2016-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR004811103T00000X
PR1089174400000X
225X00000X
PR00698235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
No103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty
No174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty