=====================================================
General NPI Number Information
=====================================================
NPI Number | 1003950577
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | WINDY HILLS THERAPY, INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/17/2007
-----------------------------------------------------
Last Update Date | 08/22/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 6921 ARMADILLO RD
-----------------------------------------------------
City | LUBBOCK
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 79407-8045
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 806-885-3374
-----------------------------------------------------
Fax | 806-885-2921
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 6921 ARMADILLO RD
-----------------------------------------------------
City | LUBBOCK
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 79407-8045
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 806-885-3374
-----------------------------------------------------
Fax | 806-885-2921
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | FOUNDER
-----------------------------------------------------
Name | MRS. CHRISTINE ANN CAUDLE
-----------------------------------------------------
Credential | OTR
-----------------------------------------------------
Telephone | 806-885-3374
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 174400000X
-----------------------------------------------------
Taxonomy Name | Specialist
-----------------------------------------------------
License Number | 2944270
-----------------------------------------------------
License Number State | DE
-----------------------------------------------------