Provider Demographics
NPI:1285097147
Name:ADL OCCUPATIONAL THERAPY, LLC
Entity type:Organization
Organization Name:ADL OCCUPATIONAL THERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HILLIARY
Authorized Official - Middle Name:
Authorized Official - Last Name:BAILEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:256-609-6946
Mailing Address - Street 1:305 W PEACHTREE ST
Mailing Address - Street 2:SUITE B
Mailing Address - City:SCOTTSBORO
Mailing Address - State:AL
Mailing Address - Zip Code:35768-4360
Mailing Address - Country:US
Mailing Address - Phone:256-609-6946
Mailing Address - Fax:256-912-0460
Practice Address - Street 1:305 W PEACHTREE ST
Practice Address - Street 2:SUITE B
Practice Address - City:SCOTTSBORO
Practice Address - State:AL
Practice Address - Zip Code:35768-4360
Practice Address - Country:US
Practice Address - Phone:256-609-6946
Practice Address - Fax:256-912-0460
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-29
Last Update Date:2019-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL184459Medicaid