Healthcare Provider Details

I. General information

NPI: 1992012660
Provider Name (Legal Business Name): SMALL HANDS BIG HEARTS PEDIATRIC THERAPY MANAGEMENT INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/01/2010
Last Update Date: 12/18/2025
Certification Date: 12/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4775 NORTH FWY
FORT WORTH TX
76106-2300
US

IV. Provider business mailing address

4775 NORTH FWY
FORT WORTH TX
76106-2300
US

V. Phone/Fax

Practice location:
  • Phone: 215-836-3131
  • Fax: 215-273-5975
Mailing address:
  • Phone: 215-836-3131
  • Fax: 215-273-5975

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QR0400X
TaxonomyRehabilitation Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: DERRICK YACOVELLI
Title or Position: BOARD MEMBER/CEO
Credential:
Phone: 610-260-4601