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General NPI Number Information
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NPI Number | 1558079665
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Entity Type | Organization
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Legal Business Name | COACH HP LLC
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Dates
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Enumeration Date | 11/08/2022
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Last Update Date | 11/08/2022
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Provider Practice Location Address
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Address Line | 21971 SW 98TH AVE
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City | CUTLER BAY
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State | FL
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Zip | 33190-1198
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Country | US
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Telephone | 702-606-8494
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Fax |
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Provider Business Mailing Address
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Address Line | 21971 SW 98TH AVE
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City | CUTLER BAY
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State | FL
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Zip | 33190-1198
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MR. HECTOR PENATE
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Credential |
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Telephone | 702-606-8494
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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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