Provider Demographics
NPI:1316664535
Name:PEAK INDEPENDENCE OCCUPATIONAL THERAPY AND WELLNESS, LLC
Entity type:Organization
Organization Name:PEAK INDEPENDENCE OCCUPATIONAL THERAPY AND WELLNESS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AMBER
Authorized Official - Middle Name:NICOLE
Authorized Official - Last Name:RICE
Authorized Official - Suffix:
Authorized Official - Credentials:OTD, OTR/L
Authorized Official - Phone:707-706-3452
Mailing Address - Street 1:9770 MOUNTAIN RD
Mailing Address - Street 2:
Mailing Address - City:CASCADE
Mailing Address - State:CO
Mailing Address - Zip Code:80809-1542
Mailing Address - Country:US
Mailing Address - Phone:707-706-3452
Mailing Address - Fax:
Practice Address - Street 1:9770 MOUNTAIN RD
Practice Address - Street 2:
Practice Address - City:CASCADE
Practice Address - State:CO
Practice Address - Zip Code:80809-1542
Practice Address - Country:US
Practice Address - Phone:707-706-3452
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-27
Last Update Date:2023-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty