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General NPI Number Information
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NPI Number | 1891133781
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Entity Type | Organization
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Legal Business Name | NOCERA ENTERPRISES, LLC
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Dates
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Enumeration Date | 06/13/2013
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Last Update Date | 06/13/2013
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Provider Practice Location Address
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Address Line | 1321 MANCHESTER DR
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City | SOUTH BEND
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State | IN
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Zip | 46615-3836
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Country | US
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Telephone | 574-232-5532
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Fax |
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Provider Business Mailing Address
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Address Line | 1321 MANCHESTER DR
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City | SOUTH BEND
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State | IN
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Zip | 46615-3836
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Country | US
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Telephone | 574-232-5532
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Fax |
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | MR. ROCCO LEOPOLD NOCERA
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Credential | MA, BCBA
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Telephone | 574-232-5532
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 252Y00000X
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Taxonomy Name | Early Intervention Provider Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251C00000X
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Taxonomy Name | Developmentally Disabled Services Day Training Agency
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License Number |
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License Number State |
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