Healthcare Provider Details

I. General information

NPI: 1174674451
Provider Name (Legal Business Name): THERAPIA INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/15/2007
Last Update Date: 05/01/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 3RD ST SUITE 202
NEPTUNE BEACH FL
32266-5072
US

IV. Provider business mailing address

1015 ATLANTIC BLVD # 214
ATLANTIC BEACH FL
32233-3313
US

V. Phone/Fax

Practice location:
  • Phone: 904-249-5020
  • Fax: 904-241-7777
Mailing address:
  • Phone: 904-249-5020
  • Fax: 904-241-7777

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0401X
TaxonomyComprehensive Outpatient Rehabilitation Facility (CORF)
License Number0701372
License Number StateFL

VIII. Authorized Official

Name: MRS. ANYA JOHNSON
Title or Position: OWNER
Credential:
Phone: 904-249-5020