MEDICARE: ADVANCED CHILDREN'S THERAPY, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	225X00000X	Occupational Therapist
2	235Z00000X	Speech-Language Pathologist
3	225200000X	Physical Therapy Assistant
4	225100000X	Physical Therapist

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	200728920A	OTHER	IN	LPI NUMBER

General Provider Information

NPI Number	:	1487879425
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ADVANCED CHILDREN'S THERAPY, INC.

Provider Business Mailing Address
First Line	:	PO BOX 40696
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46240-0696
Country	:	US
Telephone Number	:	866-566-8260
Fax Number	:

Provider Business Practice Location Address
First Line	:	5101 GUILFORD AVE
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46205-1141
Country	:	US
Telephone Number	:	866-566-8260
Fax Number	:

Authorized Official
Title or Position	:	TREASURER
Name	:	DAUD CHOWDRY
Credential	:
Telephone Number	:	866-566-8260

Provider Enumeration Date	:	04/16/2007
Last Update Date	:	11/05/2010

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Directions to “ADVANCED CHILDREN'S THERAPY, INC. ” Practice Location

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