Provider Demographics
NPI:1972103851
Name:PALM GARDEN THERAPY AT HOME, LLC
Entity type:Organization
Organization Name:PALM GARDEN THERAPY AT HOME, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT OF OPERATIONS
Authorized Official - Prefix:MR
Authorized Official - First Name:MARC
Authorized Official - Middle Name:A
Authorized Official - Last Name:LANGE
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:941-365-3534
Mailing Address - Street 1:2033 MAIN STREET
Mailing Address - Street 2:SUITE 300
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34237-6056
Mailing Address - Country:US
Mailing Address - Phone:941-365-3534
Mailing Address - Fax:
Practice Address - Street 1:2033 MAIN STREET
Practice Address - Street 2:SUITE 300
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34237-6056
Practice Address - Country:US
Practice Address - Phone:941-365-3534
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SUMMERWOOD HEALTHCARE HOLDINGS LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-10-29
Last Update Date:2020-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty