MEDICARE: ADVANCED CHILDREN'S THERAPY, INC.

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	225X00000X	Occupational Therapist
2	235Z00000X	Speech-Language Pathologist
3	225100000X	Physical Therapist

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	2045540	OTHER	TX	PHYSICAL THERAPY

General Provider Information

NPI Number	:	1386041382
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ADVANCED CHILDREN'S THERAPY, INC.

Provider Business Mailing Address
First Line	:	520 BIRDSONG DR
Second Line	:
City	:	LEAGUE CITY
State	:	TX
Zip	:	77573-2548
Country	:	US
Telephone Number	:	832-260-8993
Fax Number	:	832-426-0299

Provider Business Practice Location Address
First Line	:	520 BIRDSONG DR
Second Line	:
City	:	LEAGUE CITY
State	:	TX
Zip	:	77573-2548
Country	:	US
Telephone Number	:	832-260-8993
Fax Number	:	832-426-0299

Authorized Official
Title or Position	:	PRESIDENT
Name	:	REBECCA M MANUEL
Credential	:
Telephone Number	:	832-260-8993

Provider Enumeration Date	:	11/20/2014
Last Update Date	:	11/20/2014

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Directions to “ADVANCED CHILDREN'S THERAPY, INC. ” Practice Location

Language	Start Address	Practice Location

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