Healthcare Provider Details

I. General information

NPI: 1699237560
Provider Name (Legal Business Name): DMV HOME THERAPY OPCO LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/01/2019
Last Update Date: 04/01/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12501 PROSPERITY DR STE 160
SILVER SPRING MD
20904-1608
US

IV. Provider business mailing address

1603 E 34TH ST
BROOKLYN NY
11234-3436
US

V. Phone/Fax

Practice location:
  • Phone: 301-264-5620
  • Fax:
Mailing address:
  • Phone: 917-751-8706
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State

VIII. Authorized Official

Name: JAY AREM
Title or Position: CEO
Credential:
Phone: 917-751-8706