Provider Demographics
NPI:1447916580
Name:FOREVER HOME MODIFICATIONS
Entity type:Organization
Organization Name:FOREVER HOME MODIFICATIONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AMBER
Authorized Official - Middle Name:MORRIS
Authorized Official - Last Name:LYON
Authorized Official - Suffix:
Authorized Official - Credentials:OTRL
Authorized Official - Phone:941-724-6100
Mailing Address - Street 1:3538 FLORES AVE
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34239-5805
Mailing Address - Country:US
Mailing Address - Phone:941-724-6100
Mailing Address - Fax:
Practice Address - Street 1:3538 FLORES AVE
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34239-5805
Practice Address - Country:US
Practice Address - Phone:941-724-6100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-12
Last Update Date:2021-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225XE0001XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistEnvironmental ModificationGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty