Provider Demographics
NPI: | 1518571975 |
---|---|
Name: | SENSORY CENTRO DE DESARROLLO |
Entity Type: | Organization |
Organization Name: | SENSORY CENTRO DE DESARROLLO |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | OCCUPATIONAL THERAPY |
Authorized Official - Prefix: | |
Authorized Official - First Name: | MARIEL |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | NUNEZ RIVERA |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | OTL |
Authorized Official - Phone: | 787-391-9384 |
Mailing Address - Street 1: | 55 CALLE GUARAGUAO |
Mailing Address - Street 2: | |
Mailing Address - City: | RIO GRANDE |
Mailing Address - State: | PR |
Mailing Address - Zip Code: | 00745-5306 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 787-391-9384 |
Mailing Address - Fax: | |
Practice Address - Street 1: | EDIFICIO MULTIUSOS PBO-5 |
Practice Address - Street 2: | CALLE AUTONOMIA, ESQ. BETANCES BO. PUEBLO |
Practice Address - City: | CANOVANAS |
Practice Address - State: | PR |
Practice Address - Zip Code: | 00729 |
Practice Address - Country: | US |
Practice Address - Phone: | 787-391-9384 |
Practice Address - Fax: | |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2020-09-03 |
Last Update Date: | 2024-01-10 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 225X00000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist | Group - Multi-Specialty | |
No | 103T00000X | Behavioral Health & Social Service Providers | Psychologist | Group - Multi-Specialty | |
No | 133N00000X | Dietary & Nutritional Service Providers | Nutritionist | Group - Multi-Specialty | |
No | 224Z00000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapy Assistant | Group - Multi-Specialty | |
No | 225100000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | Group - Multi-Specialty | |
No | 225200000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapy Assistant | Group - Multi-Specialty | |
No | 2355S0801X | Speech, Language and Hearing Service Providers | Specialist/Technologist | Speech-Language Assistant | Group - Multi-Specialty |
No | 235Z00000X | Speech, Language and Hearing Service Providers | Speech-Language Pathologist | Group - Multi-Specialty |