Healthcare Provider Details

I. General information

NPI: 1962257667
Provider Name (Legal Business Name): MOVE TO MOTIVATE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/17/2024
Last Update Date: 04/17/2024
Certification Date: 04/17/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

208 W 119TH ST APT 4K
NEW YORK NY
10026-1247
US

IV. Provider business mailing address

208 W 119TH ST APT 4K
NEW YORK NY
10026-1247
US

V. Phone/Fax

Practice location:
  • Phone: 347-224-9547
  • Fax:
Mailing address:
  • Phone: 347-224-9547
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code261QR0400X
TaxonomyRehabilitation Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DOMINIQUE ROWE
Title or Position: OWNER/CEO
Credential: DPT
Phone: 347-224-9547