Provider Demographics
NPI:1558856542
Name:CONCEPT THERAPY PROFESSIONAL CORPORATION
Entity Type:Organization
Organization Name:CONCEPT THERAPY PROFESSIONAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ARKADIUSZ
Authorized Official - Middle Name:M
Authorized Official - Last Name:DEBICKI
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:574-255-8730
Mailing Address - Street 1:524 E MCKINLEY AVE STE 1
Mailing Address - Street 2:
Mailing Address - City:MISHAWAKA
Mailing Address - State:IN
Mailing Address - Zip Code:46545-6285
Mailing Address - Country:US
Mailing Address - Phone:574-255-8730
Mailing Address - Fax:574-255-8732
Practice Address - Street 1:3110 OLD US 20 W
Practice Address - Street 2:
Practice Address - City:ELKHART
Practice Address - State:IN
Practice Address - Zip Code:46514-1168
Practice Address - Country:US
Practice Address - Phone:574-327-6518
Practice Address - Fax:574-327-6697
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-06-22
Last Update Date:2020-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0401XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)