Healthcare Provider Details

I. General information

NPI: 1164169728
Provider Name (Legal Business Name): A. ROSE PEDIATRIC THERAPY CENTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/16/2022
Last Update Date: 05/05/2026
Certification Date: 05/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1082 DAVOL ST STE 204
FALL RIVER MA
02720-1124
US

IV. Provider business mailing address

53 GRAND PINE WAY
WESTPORT MA
02790-4110
US

V. Phone/Fax

Practice location:
  • Phone: 508-567-0397
  • Fax: 508-257-7088
Mailing address:
  • Phone: 508-542-7503
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2080P0006X
TaxonomyDevelopmental - Behavioral Pediatrics Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code224Z00000X
TaxonomyOccupational Therapy Assistant
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State

VIII. Authorized Official

Name: NICOLE DA PONTE
Title or Position: FOUNDER
Credential: COTA/L
Phone: 508-542-7503