Provider Demographics
NPI:1497498687
Name:BEACHES NATURE THERAPY LLC
Entity Type:Organization
Organization Name:BEACHES NATURE THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KRISTI
Authorized Official - Middle Name:
Authorized Official - Last Name:HINCKLEY
Authorized Official - Suffix:
Authorized Official - Credentials:OT
Authorized Official - Phone:904-566-1287
Mailing Address - Street 1:1136 PENMAN RD
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32250-3668
Mailing Address - Country:US
Mailing Address - Phone:904-566-1287
Mailing Address - Fax:
Practice Address - Street 1:1136 PENMAN RD
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE BEACH
Practice Address - State:FL
Practice Address - Zip Code:32250-3668
Practice Address - Country:US
Practice Address - Phone:904-566-1287
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-15
Last Update Date:2022-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty