Healthcare Provider Details

I. General information

NPI: 1316739949
Provider Name (Legal Business Name): CHILDS THERAPY SERVICE, LLC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/20/2025
Last Update Date: 05/20/2025
Certification Date: 05/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

URB LOS AIRES B1 CALLE ARGON
ARECIBO PR
00612
US

IV. Provider business mailing address

URB LOS AIRES 21 CALLE ARGON
ARECIBO PR
00612
US

V. Phone/Fax

Practice location:
  • Phone: 787-669-2550
  • Fax:
Mailing address:
  • Phone: 787-669-2550
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code224Z00000X
TaxonomyOccupational Therapy Assistant
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code2355S0801X
TaxonomySpeech-Language Assistant
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State

VIII. Authorized Official

Name: REYNALDO RIVERA ALICEA
Title or Position: PRESIDENT
Credential:
Phone: 787-669-2550