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Organization
SUPER SCHOOL THERAPY
Active
Organization
SUPER SCHOOL THERAPY
Active
Parent organization
SUPER SCHOOL
Organization subpart
Yes
Provider details
NPI number
Legal business name
SUPER SCHOOL
Authorized official
TEENA M CEBALLOS (MGR)
(562) 489-4125
Entity
Organization
Contact information
Practice address
4343 W SUNRISE BLVD, PLANTATION, FL 33313-6749
(954) 368-4981
Mailing address
4343 W SUNRISE BLVD, PLANTATION, FL 33313-6749
(954) 368-4981
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
—
—
225XP0200X
Pediatric Occupational Therapist
—
—
235Z00000X
Speech-Language Pathologist
Primary
—
—
3104A0630X
Assisted Living Facility (Behavioral Disturbances)
—
—
Other
Enumeration date
11/04/2022
Last updated
11/04/2022
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