Provider Demographics
NPI:1568230993
Name:COMMUNITY CARE THERAPY LLC
Entity Type:Organization
Organization Name:COMMUNITY CARE THERAPY LLC
Other - Org Name:HI CARE THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/MANAGER/MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:REED
Authorized Official - Suffix:
Authorized Official - Credentials:OTR/L
Authorized Official - Phone:808-501-0110
Mailing Address - Street 1:200 N VINEYARD BLVD STE A3255645
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96817-3950
Mailing Address - Country:US
Mailing Address - Phone:808-501-0110
Mailing Address - Fax:
Practice Address - Street 1:200 N VINEYARD BLVD STE A3255645
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96817-3950
Practice Address - Country:US
Practice Address - Phone:808-501-0110
Practice Address - Fax:808-204-2488
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-14
Last Update Date:2024-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225XG0600XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGerontologyGroup - Multi-Specialty