MEDICARE: THERPAY BY WATERFALL INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251C00000X	Developmentally Disabled Services Day Training Agency	14449	FL

General Provider Information

NPI Number	:	1437538444
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THERPAY BY WATERFALL INC

Provider Business Mailing Address
First Line	:	6980 NW 173RD DR APT 608
Second Line	:
City	:	HIALEAH
State	:	FL
Zip	:	33015-5515
Country	:	US
Telephone Number	:	786-278-2255
Fax Number	:

Provider Business Practice Location Address
First Line	:	6980 NW 173RD DR
Second Line	:	APT 608
City	:	HIALEAH
State	:	FL
Zip	:	33015-5515
Country	:	US
Telephone Number	:	786-278-2255
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	ARIANNA GARCIA
Credential	:
Telephone Number	:	786-278-2255

Provider Enumeration Date	:	05/22/2015
Last Update Date	:	05/22/2015

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Directions to “THERPAY BY WATERFALL INC ” Practice Location

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