Provider Demographics
NPI:1386005734
Name:CLIMBING TREE THERAPY
Entity Type:Organization
Organization Name:CLIMBING TREE THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:HUGHES
Authorized Official - Suffix:
Authorized Official - Credentials:MOTR/L
Authorized Official - Phone:505-385-8028
Mailing Address - Street 1:14107 SKYLINE RD NE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87123-2333
Mailing Address - Country:US
Mailing Address - Phone:505-385-8028
Mailing Address - Fax:855-254-6287
Practice Address - Street 1:2301 YALE BLVD SE
Practice Address - Street 2:SUITE A3
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87106-4228
Practice Address - Country:US
Practice Address - Phone:505-385-8028
Practice Address - Fax:855-254-6287
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-14
Last Update Date:2016-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM69727058Medicaid