Healthcare Provider Details

I. General information

NPI: 1750181566
Provider Name (Legal Business Name): TERRIFIC THERAPY AND CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/19/2025
Last Update Date: 03/19/2025
Certification Date: 03/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

137 RIDGEMOOR DR
GLEN CARBON IL
62034-1845
US

IV. Provider business mailing address

137 RIDGEMOOR DR
GLEN CARBON IL
62034-1845
US

V. Phone/Fax

Practice location:
  • Phone: 618-792-1585
  • Fax:
Mailing address:
  • Phone: 618-792-1585
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code224Z00000X
TaxonomyOccupational Therapy Assistant
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 6
Primary TaxonomyY
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DONISHA THOMPSON
Title or Position: OWNER
Credential:
Phone: 618-792-1585