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 |