Provider Demographics
NPI:1629500939
Name:THERAHEALTH & WELLNESS LLC
Entity Type:Organization
Organization Name:THERAHEALTH & WELLNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:JONATHAN
Authorized Official - Middle Name:D
Authorized Official - Last Name:HODEL
Authorized Official - Suffix:
Authorized Official - Credentials:PTA
Authorized Official - Phone:561-291-7922
Mailing Address - Street 1:631 US HIGHWAY 1 STE 305
Mailing Address - Street 2:
Mailing Address - City:NORTH PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33408-4620
Mailing Address - Country:US
Mailing Address - Phone:561-291-7922
Mailing Address - Fax:561-409-0876
Practice Address - Street 1:631 US HIGHWAY 1 STE 305
Practice Address - Street 2:
Practice Address - City:NORTH PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33408-4620
Practice Address - Country:US
Practice Address - Phone:561-291-7922
Practice Address - Fax:561-409-0876
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-28
Last Update Date:2021-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation