Provider Demographics
NPI:1568602175
Name:MCB THERAPY SERVICES,INC.
Entity Type:Organization
Organization Name:MCB THERAPY SERVICES,INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:CIELITO
Authorized Official - Last Name:BERIN
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:812-361-1648
Mailing Address - Street 1:341 S WOODFIELD LN
Mailing Address - Street 2:
Mailing Address - City:BLOOMINGTON
Mailing Address - State:IN
Mailing Address - Zip Code:47403-9070
Mailing Address - Country:US
Mailing Address - Phone:812-361-1648
Mailing Address - Fax:812-825-8815
Practice Address - Street 1:341 S WOODFIELD LN
Practice Address - Street 2:
Practice Address - City:BLOOMINGTON
Practice Address - State:IN
Practice Address - Zip Code:47403-9070
Practice Address - Country:US
Practice Address - Phone:812-361-1648
Practice Address - Fax:812-825-8815
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-23
Last Update Date:2009-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN05006267A252Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency