Provider Demographics
NPI:1578826764
Name:SIERRA MADRE LEARNING CENTER/TOTAL PROGRAMS LLC
Entity Type:Organization
Organization Name:SIERRA MADRE LEARNING CENTER/TOTAL PROGRAMS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:SEAN
Authorized Official - Middle Name:
Authorized Official - Last Name:SURFAS
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:626-355-5160
Mailing Address - Street 1:370 W SIERRA MADRE BLVD
Mailing Address - Street 2:#B
Mailing Address - City:SIERRA MADRE
Mailing Address - State:CA
Mailing Address - Zip Code:91024-2354
Mailing Address - Country:US
Mailing Address - Phone:626-355-5160
Mailing Address - Fax:626-355-5173
Practice Address - Street 1:370 W SIERRA MADRE BLVD
Practice Address - Street 2:#B
Practice Address - City:SIERRA MADRE
Practice Address - State:CA
Practice Address - Zip Code:91024-2354
Practice Address - Country:US
Practice Address - Phone:626-355-5160
Practice Address - Fax:626-355-5173
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-21
Last Update Date:2012-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
No251B00000XAgenciesCase Management
No251S00000XAgenciesCommunity/Behavioral Health
No252Y00000XAgenciesEarly Intervention Provider Agency