Provider Demographics
NPI:1558083873
Name:SENSORY PENGUIN LLC
Entity Type:Organization
Organization Name:SENSORY PENGUIN LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:CHAYA
Authorized Official - Middle Name:
Authorized Official - Last Name:EDELKOPF
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-361-5330
Mailing Address - Street 1:1108 E MAIN ST STE 906-2716
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23219-3539
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1108 E MAIN ST STE 906-2716
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23219-3539
Practice Address - Country:US
Practice Address - Phone:786-361-5330
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-13
Last Update Date:2022-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty