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General NPI Number Information
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NPI Number | 1366111536
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Entity Type | Organization
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Legal Business Name | PURE THERAPY ONE LLC.
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Dates
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Enumeration Date | 09/10/2021
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Last Update Date | 04/15/2024
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Provider Practice Location Address
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Address Line | 8950 SW 152ND ST
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City | PALMETTO BAY
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State | FL
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Zip | 33157-2064
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Country | US
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Telephone | 786-678-0789
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Fax | 786-732-6091
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Provider Business Mailing Address
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Address Line | 8950 SW 152ND ST UNIT R
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City | PALMETTO BAY
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State | FL
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Zip | 33157-2064
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Country | US
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Telephone | 786-678-0789
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Fax | 786-732-6091
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Authorized Official
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Title or Position | ADMINSTRATOR
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Name | RAKIYA TAMARA DENNY
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Credential |
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Telephone | 786-678-0789
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 174200000X
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Taxonomy Name | Meals Provider
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 261QH0700X
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Taxonomy Name | Hearing and Speech Clinic/Center
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 261QM0855X
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Taxonomy Name | Adolescent and Children Mental Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number |
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License Number State |
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Taxonomy #8
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Taxonomy Code | 343800000X
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Taxonomy Name | Secured Medical Transport (VAN)
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License Number |
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License Number State |
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Taxonomy #9
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Taxonomy Code | 343900000X
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Taxonomy Name | Non-emergency Medical Transport (VAN)
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License Number |
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License Number State |
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Taxonomy #10
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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