Healthcare Provider Details

I. General information

NPI: 1679381701
Provider Name (Legal Business Name): ENCOMPASS THERAPY CENTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/20/2024
Last Update Date: 12/20/2024
Certification Date: 12/11/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3710 KATALIN CT
BAY CITY MI
48706-2160
US

IV. Provider business mailing address

3710 KATALIN CT
BAY CITY MI
48706-2160
US

V. Phone/Fax

Practice location:
  • Phone: 989-324-2012
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
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: ASHLEY BLAKE
Title or Position: CEO/OWNER
Credential:
Phone: 989-324-2012