Provider Demographics
NPI:1811881899
Name:AQUA THERAPY PLUS LLC
Entity type:Organization
Organization Name:AQUA THERAPY PLUS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MORDECHAI
Authorized Official - Middle Name:
Authorized Official - Last Name:KAHAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-830-3203
Mailing Address - Street 1:12 BUCKINGHAM DR
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:NJ
Mailing Address - Zip Code:08527-2605
Mailing Address - Country:US
Mailing Address - Phone:248-830-3203
Mailing Address - Fax:
Practice Address - Street 1:12 BUCKINGHAM DR
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:NJ
Practice Address - Zip Code:08527-2605
Practice Address - Country:US
Practice Address - Phone:248-830-3203
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-06-05
Last Update Date:2025-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty