MEDICARE: LATINO LEARNING CENTER, 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	261QA0600X	Adult Day Care Clinic/Center		TX

General Provider Information

NPI Number	:	1477752871
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LATINO LEARNING CENTER, INC.

Provider Business Mailing Address
First Line	:	3522 POLK ST
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77003-4844
Country	:	US
Telephone Number	:	713-223-1391
Fax Number	:	713-222-2338

Provider Business Practice Location Address
First Line	:	3522 POLK ST
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77003-4844
Country	:	US
Telephone Number	:	713-223-1391
Fax Number	:	713-222-2338

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	MR. JOE PAUL ZEPEDA
Credential	:
Telephone Number	:	713-223-1391

Provider Enumeration Date	:	07/16/2007
Last Update Date	:	07/16/2007

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