Provider Demographics
NPI:1003079617
Name:NAADOM THERAPY SERVICES
Entity Type:Organization
Organization Name:NAADOM THERAPY SERVICES
Other - Org Name:NEW HORIZON REHAB
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SENA
Authorized Official - Middle Name:G
Authorized Official - Last Name:MORTEY
Authorized Official - Suffix:
Authorized Official - Credentials:OTR/L
Authorized Official - Phone:321-271-6655
Mailing Address - Street 1:966 SIBONEY ST NW
Mailing Address - Street 2:
Mailing Address - City:PALM BAY
Mailing Address - State:FL
Mailing Address - Zip Code:32907-1773
Mailing Address - Country:US
Mailing Address - Phone:321-271-6655
Mailing Address - Fax:321-951-1863
Practice Address - Street 1:966 SIBONEY ST NW
Practice Address - Street 2:
Practice Address - City:PALM BAY
Practice Address - State:FL
Practice Address - Zip Code:32907-1773
Practice Address - Country:US
Practice Address - Phone:321-271-6655
Practice Address - Fax:321-951-1863
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-03
Last Update Date:2008-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT 9277225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty