Provider Demographics
NPI: | 1972806990 |
---|---|
Name: | HIGH QUALITY HOME THERAPY LLC |
Entity type: | Organization |
Organization Name: | HIGH QUALITY HOME THERAPY LLC |
Other - Org Name: | <UNAVAIL> |
Other - Org Type: | |
Authorized Official - Title/Position: | PRESIDENT/CEO |
Authorized Official - Prefix: | |
Authorized Official - First Name: | CARYN |
Authorized Official - Middle Name: | B |
Authorized Official - Last Name: | MCALLISTER |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | PT |
Authorized Official - Phone: | 203-212-4191 |
Mailing Address - Street 1: | 30 BUXTON FARM RD STE 230 |
Mailing Address - Street 2: | |
Mailing Address - City: | STAMFORD |
Mailing Address - State: | CT |
Mailing Address - Zip Code: | 06905-1206 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 203-212-4191 |
Mailing Address - Fax: | 203-212-4191 |
Practice Address - Street 1: | 30 BUXTON FARM RD STE 230 |
Practice Address - Street 2: | |
Practice Address - City: | STAMFORD |
Practice Address - State: | CT |
Practice Address - Zip Code: | 06905-1206 |
Practice Address - Country: | US |
Practice Address - Phone: | 203-212-4191 |
Practice Address - Fax: | 203-212-4191 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2010-12-13 |
Last Update Date: | 2019-03-07 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
103TC0700X, 163W00000X, 208D00000X, 224Z00000X, 225100000X, 225200000X, 225700000X, 225X00000X, 235Z00000X | ||
CT | 005578 | 251E00000X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 225200000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapy Assistant | Group - Multi-Specialty | |
No | 103TC0700X | Behavioral Health & Social Service Providers | Psychologist | Clinical | Group - Multi-Specialty |
No | 163W00000X | Nursing Service Providers | Registered Nurse | Group - Multi-Specialty | |
No | 208D00000X | Allopathic & Osteopathic Physicians | General Practice | Group - Multi-Specialty | |
No | 224Z00000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapy Assistant | Group - Multi-Specialty | |
No | 225100000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | Group - Multi-Specialty | |
No | 225700000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Massage Therapist | Group - Multi-Specialty | |
No | 225X00000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist | Group - Multi-Specialty | |
No | 235Z00000X | Speech, Language and Hearing Service Providers | Speech-Language Pathologist | Group - Multi-Specialty | |
No | 251E00000X | Agencies | Home Health | Group - Multi-Specialty |