Provider Demographics
NPI:1598423014
Name:EINSTEIN THERAPY CENTER, INC.
Entity Type:Organization
Organization Name:EINSTEIN THERAPY CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING SPECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:ALICIA
Authorized Official - Middle Name:
Authorized Official - Last Name:WHITE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:352-505-6363
Mailing Address - Street 1:229 SW MAIN BLVD
Mailing Address - Street 2:
Mailing Address - City:LAKE CITY
Mailing Address - State:FL
Mailing Address - Zip Code:32025-7049
Mailing Address - Country:US
Mailing Address - Phone:386-515-3009
Mailing Address - Fax:352-505-6383
Practice Address - Street 1:229 SW MAIN BLVD
Practice Address - Street 2:
Practice Address - City:LAKE CITY
Practice Address - State:FL
Practice Address - Zip Code:32025-7049
Practice Address - Country:US
Practice Address - Phone:386-515-3009
Practice Address - Fax:352-505-6383
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FUNDAMENTAL THERAPY SOLUTIONS LAKE CITY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-12-01
Last Update Date:2021-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center