MEDICARE: GENTLECARE THERAPY LLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	103K00000X	Behavior Analyst
2	106E00000X	Assistant Behavior Analyst
3	106S00000X	Behavior Technician
4	174400000X	Specialist
5	2080P0006X	Developmental - Behavioral Pediatrics Physician
6	222Q00000X	Developmental Therapist
7	225100000X	Physical Therapist
8	225CX0006X	Orientation and Mobility Training Rehabilitation Counselor
9	225X00000X	Occupational Therapist
10	231H00000X	Audiologist
11	231HA2400X	Assistive Technology Practitioner Audiologist
12	235Z00000X	Speech-Language Pathologist
13	252Y00000X	Early Intervention Provider Agency

General Provider Information

NPI Number	:	1376996116
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GENTLECARE THERAPY LLC

Provider Business Mailing Address
First Line	:	3675 MARKET ST STE 200
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19104-2608
Country	:	US
Telephone Number	:	267-800-7566
Fax Number	:

Provider Business Practice Location Address
First Line	:	88 S LAKEVIEW DR
Second Line	:
City	:	GIBBSBORO
State	:	NJ
Zip	:	08026-1229
Country	:	US
Telephone Number	:	856-484-5535
Fax Number	:	267-907-8269

Authorized Official
Title or Position	:	DIRECTOR
Name	:	MORRIS WACHS
Credential	:
Telephone Number	:	267-800-7566

Provider Enumeration Date	:	07/17/2016
Last Update Date	:	01/09/2025

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