Provider Demographics
NPI:1295464683
Name:ONECARE PEDIATRIC THERAPY, LLC
Entity Type:Organization
Organization Name:ONECARE PEDIATRIC THERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:
Authorized Official - Last Name:EDROSA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-587-3131
Mailing Address - Street 1:3087 E WARM SPRINGS RD STE 200A
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89120-3754
Mailing Address - Country:US
Mailing Address - Phone:702-333-4742
Mailing Address - Fax:702-333-4743
Practice Address - Street 1:3087 E WARM SPRINGS RD STE 200A
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89120-3754
Practice Address - Country:US
Practice Address - Phone:702-333-4742
Practice Address - Fax:702-333-4743
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-09
Last Update Date:2022-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty