Healthcare Provider Details
I. General information
NPI: 1811184450
Provider Name (Legal Business Name): HOME THERAPY SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/27/2007
Last Update Date: 12/27/2019
Certification Date: 12/27/2019
Deactivation Date:
Reactivation Date:
III. Provider practice location address
7310 GROVE RD STE 203
FREDERICK MD
21704-5139
US
IV. Provider business mailing address
1916 KINGS FOREST TRL
MOUNT AIRY MD
21771-8745
US
V. Phone/Fax
- Phone: 301-829-6770
- Fax: 301-829-6610
- Phone: 301-829-6770
- Fax: 301-829-6610
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 225100000X |
| Taxonomy | Physical Therapist |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 225X00000X |
| Taxonomy | Occupational Therapist |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 235Z00000X |
| Taxonomy | Speech-Language Pathologist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MR.
RICHARD
EDWARD
DIXON
JR.
Title or Position: PRESIDENT
Credential: DPT
Phone: 301-829-6770