Provider Demographics
NPI: | 1881239614 |
---|---|
Name: | SENDERO EDUCATIVO, LLC |
Entity type: | Organization |
Organization Name: | SENDERO EDUCATIVO, LLC |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | PRESIDENTE |
Authorized Official - Prefix: | |
Authorized Official - First Name: | YARITZA |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | SEMIDEY |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 787-382-7319 |
Mailing Address - Street 1: | CANOVANAS MALL ENRIQUE MANGUAL LOCAL #14 |
Mailing Address - Street 2: | CARR. 185 KM. 1.0 |
Mailing Address - City: | CANOVANAS |
Mailing Address - State: | PR |
Mailing Address - Zip Code: | 00729 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 787-382-7319 |
Mailing Address - Fax: | |
Practice Address - Street 1: | CANOVANAS MALL ENRIQUE MANGUAL LOCAL #14 |
Practice Address - Street 2: | CARR. 185 KM. 1.0 |
Practice Address - City: | CANOVANAS |
Practice Address - State: | PR |
Practice Address - Zip Code: | 00729 |
Practice Address - Country: | US |
Practice Address - Phone: | 787-382-7319 |
Practice Address - Fax: | |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2019-11-15 |
Last Update Date: | 2020-02-03 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 103TP2701X | Behavioral Health & Social Service Providers | Psychologist | Group Psychotherapy | Group - Multi-Specialty |
No | 224Z00000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapy Assistant | Group - Multi-Specialty | |
No | 224ZE0001X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapy Assistant | Environmental Modification | Group - Multi-Specialty |
No | 224ZF0002X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapy Assistant | Feeding, Eating & Swallowing | Group - Multi-Specialty |
No | 224ZL0004X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapy Assistant | Low Vision | Group - Multi-Specialty |
No | 235Z00000X | Speech, Language and Hearing Service Providers | Speech-Language Pathologist | Group - Multi-Specialty |