Provider Demographics
NPI:1073709036
Name:ENCOMPASS THERAPY, LLC
Entity Type:Organization
Organization Name:ENCOMPASS THERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:BARBARA
Authorized Official - Last Name:MOORE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:434-882-0676
Mailing Address - Street 1:1410 BEACON HL
Mailing Address - Street 2:
Mailing Address - City:AFTON
Mailing Address - State:VA
Mailing Address - Zip Code:22920-9600
Mailing Address - Country:US
Mailing Address - Phone:434-882-0676
Mailing Address - Fax:
Practice Address - Street 1:4416 IVY COMMONS
Practice Address - Street 2:
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22903-7123
Practice Address - Country:US
Practice Address - Phone:434-249-3756
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-24
Last Update Date:2010-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305202139261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAC10360Medicare PIN