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General NPI Number Information
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NPI Number | 1992012660
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Entity Type | Organization
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Legal Business Name | SMALL HANDS BIG HEARTS PEDIATRIC THERAPY MANAGEMENT INC
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Dates
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Enumeration Date | 09/01/2010
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Last Update Date | 12/18/2025
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Provider Practice Location Address
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Address Line | 4775 NORTH FWY
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City | FORT WORTH
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State | TX
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Zip | 76106-2300
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Country | US
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Telephone | 215-836-3131
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Fax | 215-273-5975
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Provider Business Mailing Address
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Address Line | 4775 NORTH FWY
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City | FORT WORTH
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State | TX
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Zip | 76106-2300
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Country | US
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Telephone | 215-836-3131
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Fax | 215-273-5975
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Authorized Official
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Title or Position | BOARD MEMBER/CEO
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Name | DERRICK YACOVELLI
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Credential |
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Telephone | 610-260-4601
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0400X
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Taxonomy Name | Rehabilitation Clinic/Center
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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 | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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