Provider Demographics
NPI:1336875160
Name:CENTRO TERAPEUTICO FAMILIAR, LLC
Entity Type:Organization
Organization Name:CENTRO TERAPEUTICO FAMILIAR, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SLP, OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LEISHLY
Authorized Official - Middle Name:M
Authorized Official - Last Name:NIEVES-FERRER
Authorized Official - Suffix:
Authorized Official - Credentials:SLP
Authorized Official - Phone:939-326-1888
Mailing Address - Street 1:13-A O-708
Mailing Address - Street 2:URB ALTURAS
Mailing Address - City:RIO GRANDE
Mailing Address - State:PR
Mailing Address - Zip Code:00745
Mailing Address - Country:US
Mailing Address - Phone:939-326-1888
Mailing Address - Fax:
Practice Address - Street 1:CARR 8860 KM 1.5 PLAZA MATIENZO SHOPPING CENTER
Practice Address - Street 2:EDIF. A 2ND FLOOR SUITE #3
Practice Address - City:TRUJILLO ALTO
Practice Address - State:PR
Practice Address - Zip Code:00977
Practice Address - Country:US
Practice Address - Phone:939-326-1888
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-25
Last Update Date:2022-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty