Provider Demographics
NPI:1144645029
Name:RED BIRD OT SERVICES, LLC
Entity type:Organization
Organization Name:RED BIRD OT SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OCCUPATIONAL THERAPIST/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LORI
Authorized Official - Middle Name:JEAN
Authorized Official - Last Name:GILBERT
Authorized Official - Suffix:
Authorized Official - Credentials:OTR/L
Authorized Official - Phone:603-534-3918
Mailing Address - Street 1:197 OLD DOVER RD
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NH
Mailing Address - Zip Code:03867-4550
Mailing Address - Country:US
Mailing Address - Phone:603-534-3918
Mailing Address - Fax:
Practice Address - Street 1:197 OLD DOVER RD
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03867-4550
Practice Address - Country:US
Practice Address - Phone:603-534-3918
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-02-28
Last Update Date:2014-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH0582225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty