Provider Demographics
NPI:1164652525
Name:CASTLE THERAPY
Entity Type:Organization
Organization Name:CASTLE THERAPY
Other - Org Name:CASTLE SPEECH THERAPY
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:REMAI
Authorized Official - Middle Name:JACQUELINE
Authorized Official - Last Name:ECKHARDT
Authorized Official - Suffix:
Authorized Official - Credentials:MS,CCC-SLP
Authorized Official - Phone:772-215-3335
Mailing Address - Street 1:8825 SE LONGVIEW DR
Mailing Address - Street 2:
Mailing Address - City:HOBE SOUND
Mailing Address - State:FL
Mailing Address - Zip Code:33455-7420
Mailing Address - Country:US
Mailing Address - Phone:772-215-3335
Mailing Address - Fax:
Practice Address - Street 1:8825 SE LONGVIEW DR
Practice Address - Street 2:
Practice Address - City:HOBE SOUND
Practice Address - State:FL
Practice Address - Zip Code:33455-7420
Practice Address - Country:US
Practice Address - Phone:772-215-3335
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-20
Last Update Date:2009-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA 7527235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty