Provider Demographics
NPI:1932709177
Name:RISING STAR PRESCHOOL
Entity Type:Organization
Organization Name:RISING STAR PRESCHOOL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:TERRI
Authorized Official - Middle Name:
Authorized Official - Last Name:BERCASIO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:619-213-9356
Mailing Address - Street 1:3040 FAIRMOUNT AVE
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92105-4639
Mailing Address - Country:US
Mailing Address - Phone:613-219-9356
Mailing Address - Fax:
Practice Address - Street 1:3040 FAIRMOUNT AVE
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92105-4639
Practice Address - Country:US
Practice Address - Phone:613-219-9356
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-27
Last Update Date:2020-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency