Provider Demographics
NPI:1679819957
Name:THE OCCUPATIONAL THERAPY CENTER, LLC
Entity Type:Organization
Organization Name:THE OCCUPATIONAL THERAPY CENTER, LLC
Other - Org Name:THE PEDIATRIC THERAPY CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:REGISTERED AGENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:BUTLER
Authorized Official - Last Name:HAMM
Authorized Official - Suffix:
Authorized Official - Credentials:OTR/L
Authorized Official - Phone:256-683-1582
Mailing Address - Street 1:417 HILL AVE
Mailing Address - Street 2:
Mailing Address - City:GUNTERSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35976-1115
Mailing Address - Country:US
Mailing Address - Phone:256-683-1582
Mailing Address - Fax:
Practice Address - Street 1:627 E MAIN ST
Practice Address - Street 2:
Practice Address - City:ALBERTVILLE
Practice Address - State:AL
Practice Address - Zip Code:35950-2461
Practice Address - Country:US
Practice Address - Phone:256-849-0444
Practice Address - Fax:256-849-0445
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-12-14
Last Update Date:2019-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1381225X00000X
261QM1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty