Healthcare Provider Details

I. General information

NPI: 1790305191
Provider Name (Legal Business Name): ANCHORS AWAY THERAPY SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/26/2020
Last Update Date: 04/26/2020
Certification Date: 04/26/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3901 RIVERWALK CT
BRADENTON FL
34208-8052
US

IV. Provider business mailing address

3901 RIVERWALK CT
BRADENTON FL
34208-8052
US

V. Phone/Fax

Practice location:
  • Phone: 817-718-3198
  • Fax:
Mailing address:
  • Phone: 817-718-3198
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QA3000X
TaxonomyAugmentative Communication Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code261QH0700X
TaxonomyHearing and Speech Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MRS. MICHELLE RENE EARNEST
Title or Position: OWNER/SPEECH LANGUAGE PATHOLOGIST
Credential: MA, CCC-SLP
Phone: 817-718-3198