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General NPI Number Information
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NPI Number | 1437723533
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Entity Type | Organization
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Legal Business Name | RISING STAR CENTER CORPORATION
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Dates
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Enumeration Date | 05/14/2021
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Last Update Date | 09/18/2021
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Provider Practice Location Address
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Address Line | 4600 SW 97TH CT
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City | MIAMI
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State | FL
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Zip | 33165-5756
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Country | US
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Telephone | 786-357-2675
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Fax |
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Provider Business Mailing Address
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Address Line | 4600 SW 97TH CT
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City | MIAMI
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State | FL
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Zip | 33165-5756
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Country | US
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Telephone | 786-357-2675
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | ISIS PADILLA GALIS-MENENDEZ
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Credential |
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Telephone | 786-357-2675
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number |
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License Number State |
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