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General NPI Number Information
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NPI Number | 1497027478
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Entity Type | Organization
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Legal Business Name | ELEUTHERIA, LLC
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Dates
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Enumeration Date | 02/06/2012
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Last Update Date | 12/10/2020
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Provider Practice Location Address
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Address Line | 13385 W MCDOWELL RD
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City | GOODYEAR
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State | AZ
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Zip | 85395-2631
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Country | US
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Telephone | 623-986-5110
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Fax | 623-207-9683
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Provider Business Mailing Address
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Address Line | 13385 W MCDOWELL RD
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City | GOODYEAR
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State | AZ
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Zip | 85395-2631
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Country | US
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Telephone | 623-986-5110
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Fax | 623-207-9683
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Authorized Official
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Title or Position | OWNER/SPEECH LANGUAGE PATHOLOGIST
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Name | MS. TERESA CHACE
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Credential | MS SLP-CCC
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Telephone | 623-698-5747
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 224Z00000X
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Taxonomy Name | Occupational Therapy Assistant
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License Number | 5407
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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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 | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | MT14880
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License Number State | AZ
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Taxonomy #4
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 4415
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License Number State | AZ
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Taxonomy #5
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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 #6
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Taxonomy Code | 2355S0801X
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Taxonomy Name | Speech-Language Assistant
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License Number | SLPA7585
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License Number State | AZ
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Taxonomy #7
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | SLP4009
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License Number State | AZ
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Taxonomy #8
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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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 | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | SLP5608
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License Number State | AZ
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