Provider Demographics
NPI:1871099689
Name:AMERICAN THERAPY HOUSE
Entity type:Organization
Organization Name:AMERICAN THERAPY HOUSE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:EILEEN
Authorized Official - Middle Name:SUE
Authorized Official - Last Name:DE OLIVEIRA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-608-9930
Mailing Address - Street 1:1495 N PARK DR
Mailing Address - Street 2:
Mailing Address - City:WESTON
Mailing Address - State:FL
Mailing Address - Zip Code:33326-3215
Mailing Address - Country:US
Mailing Address - Phone:954-608-9930
Mailing Address - Fax:954-241-6726
Practice Address - Street 1:4959 PALO VERDE ST STE 105C
Practice Address - Street 2:
Practice Address - City:MONTCLAIR
Practice Address - State:CA
Practice Address - Zip Code:91763-2359
Practice Address - Country:US
Practice Address - Phone:909-929-0743
Practice Address - Fax:954-241-6726
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-04-02
Last Update Date:2018-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty