Provider Demographics
NPI:1396036638
Name:FOF OCCUPATIONAL THERAPY SERVICES LLC
Entity Type:Organization
Organization Name:FOF OCCUPATIONAL THERAPY SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:KIM
Authorized Official - Middle Name:BELINDA
Authorized Official - Last Name:HIGH
Authorized Official - Suffix:
Authorized Official - Credentials:OTR/L
Authorized Official - Phone:410-484-2761
Mailing Address - Street 1:1700 REISTERSTOWN RD
Mailing Address - Street 2:SUITE# 217
Mailing Address - City:PIKESVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21208-1416
Mailing Address - Country:US
Mailing Address - Phone:410-484-2761
Mailing Address - Fax:410-484-2762
Practice Address - Street 1:1700 REISTERSTOWN RD
Practice Address - Street 2:SUITE# 217
Practice Address - City:PIKESVILLE
Practice Address - State:MD
Practice Address - Zip Code:21208-1416
Practice Address - Country:US
Practice Address - Phone:410-484-2761
Practice Address - Fax:410-484-2762
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-20
Last Update Date:2011-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD240M340FMedicare PIN