Healthcare Provider Details

I. General information

NPI: 1447014337
Provider Name (Legal Business Name): TEACHTEAM NFP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/12/2024
Last Update Date: 12/05/2024
Certification Date: 12/05/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17500 N BAY RD APT 608S
SUNNY ISLES BEACH FL
33160-2856
US

IV. Provider business mailing address

17500 N BAY RD APT 608S
SUNNY ISLES BEACH FL
33160-2856
US

V. Phone/Fax

Practice location:
  • Phone: 708-927-3556
  • Fax:
Mailing address:
  • Phone: 708-927-3556
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code251K00000X
TaxonomyPublic Health or Welfare Agency
License Number
License Number StateNULL
# 4
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number StateNULL
# 5
Primary TaxonomyN
Taxonomy Code251300000X
TaxonomyLocal Education Agency (LEA)
License Number
License Number StateNULL

VIII. Authorized Official

Name: MARC P MERCADO
Title or Position: PRESIDENT
Credential:
Phone: 708-927-3556