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General NPI Number Information
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NPI Number | 1447916580
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Entity Type | Organization
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Legal Business Name | FOREVER HOME MODIFICATIONS
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Dates
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Enumeration Date | 11/12/2021
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Last Update Date | 11/12/2021
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Provider Practice Location Address
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Address Line | 3538 FLORES AVE
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City | SARASOTA
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State | FL
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Zip | 34239-5805
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Country | US
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Telephone | 941-724-6100
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Fax |
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Provider Business Mailing Address
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Address Line | 3538 FLORES AVE
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City | SARASOTA
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State | FL
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Zip | 34239-5805
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Country | US
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Telephone | 941-724-6100
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Fax |
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Authorized Official
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Title or Position | CO-OWNER
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Name | AMBER MORRIS LYON
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Credential | OTRL
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Telephone | 941-724-6100
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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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 | 225XE0001X
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Taxonomy Name | Environmental Modification Occupational Therapist
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License Number |
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License Number State |
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