Provider Demographics
NPI:1164823563
Name:AUTHENTICARE THERAPY SERVICES INC
Entity Type:Organization
Organization Name:AUTHENTICARE THERAPY SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:GLENN
Authorized Official - Middle Name:
Authorized Official - Last Name:JOSEPH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-645-2986
Mailing Address - Street 1:200 FRANDORSON CIR
Mailing Address - Street 2:SUITE 203
Mailing Address - City:APOLLO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33572-2689
Mailing Address - Country:US
Mailing Address - Phone:813-645-2986
Mailing Address - Fax:866-686-7196
Practice Address - Street 1:200 FRANDORSON CIR
Practice Address - Street 2:SUITE 203
Practice Address - City:APOLLO BEACH
Practice Address - State:FL
Practice Address - Zip Code:33572-2689
Practice Address - Country:US
Practice Address - Phone:813-645-2986
Practice Address - Fax:866-686-7196
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-04
Last Update Date:2014-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes227900000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, RegisteredGroup - Multi-Specialty