Healthcare Provider Details

I. General information

NPI: 1528356466
Provider Name (Legal Business Name): ENRICHMENT THERAPIES PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/13/2011
Last Update Date: 08/26/2026
Certification Date: 08/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

740 COMMUNITY DRIVE SUITE A
NORTH LIBERTY IA
52317-9498
US

IV. Provider business mailing address

740 COMMUNITY DRIVE SUITE A
NORTH LIBERTY IA
52317-9498
US

V. Phone/Fax

Practice location:
  • Phone: 319-626-2553
  • Fax:
Mailing address:
  • Phone: 319-621-1137
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License Number002093
License Number StateIA

VIII. Authorized Official

Name: RENEE COX
Title or Position: ADMINISTRATIVE DIRECTOR
Credential:
Phone: 319-626-2553