=====================================================
General NPI Number Information
=====================================================
NPI Number | 1750349650
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | CARING HANDS PEDIATRIC THERAPY, INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/02/2006
-----------------------------------------------------
Last Update Date | 08/22/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1531 WESTBROOK PLAZA DR
-----------------------------------------------------
City | WINSTON-SALEM
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 27103-1330
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 336-659-1215
-----------------------------------------------------
Fax | 336-768-4545
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1531 WESTBROOK PLAZA DR SUITE C
-----------------------------------------------------
City | WINSTON SALEM
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 27103-1330
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 336-659-1215
-----------------------------------------------------
Fax | 336-768-4545
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | MRS. MERRILEE STAR ROJAS
-----------------------------------------------------
Credential | OTR/L
-----------------------------------------------------
Telephone | 336-659-1215
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 174400000X
-----------------------------------------------------
Taxonomy Name | Specialist
-----------------------------------------------------
License Number | 1858
-----------------------------------------------------
License Number State | NC
-----------------------------------------------------