Provider Demographics
NPI:1720974181
Name:LS INNOVATIVE EDUCATION CENTER, INC.
Entity type:Organization
Organization Name:LS INNOVATIVE EDUCATION CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CESAR
Authorized Official - Middle Name:A
Authorized Official - Last Name:VARGAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-633-4007
Mailing Address - Street 1:CALLE JUAN SAN ANTONIO EDIFICIO 207
Mailing Address - Street 2:
Mailing Address - City:MOCA
Mailing Address - State:PR
Mailing Address - Zip Code:00676-1561
Mailing Address - Country:US
Mailing Address - Phone:787-818-0100
Mailing Address - Fax:
Practice Address - Street 1:207 CALLE JUAN SAN ANTONIO
Practice Address - Street 2:
Practice Address - City:MOCA
Practice Address - State:PR
Practice Address - Zip Code:00676-4146
Practice Address - Country:US
Practice Address - Phone:787-818-0100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-06-13
Last Update Date:2025-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center