MEDICARE: THERAPY BY DESIGN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	320600000X	Intellectual and/or Developmental Disabilities Residential Treatment Facility	10304	FL

General Provider Information

NPI Number	:	1154413656
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THERAPY BY DESIGN

Provider Business Mailing Address
First Line	:	1709 BELMONT LN
Second Line	:
City	:	NORTH LAUDERDALE
State	:	FL
Zip	:	33068-4285
Country	:	US
Telephone Number	:	954-720-5560
Fax Number	:

Provider Business Practice Location Address
First Line	:	1709 BELMONT LN
Second Line	:
City	:	NORTH LAUDERDALE
State	:	FL
Zip	:	33068-4285
Country	:	US
Telephone Number	:	954-720-5560
Fax Number	:

Authorized Official
Title or Position	:	COOTA/L
Name	:	RANDI F. ADLER
Credential	:	OTA/L
Telephone Number	:	754-234-7652

Provider Enumeration Date	:	09/29/2006
Last Update Date	:	07/21/2022

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Directions to “THERAPY BY DESIGN ” Practice Location

Language	Start Address	Practice Location

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