Provider Demographics
NPI:1740406636
Name:PEDIATRIC THERAPY & BEYOND, INC
Entity Type:Organization
Organization Name:PEDIATRIC THERAPY & BEYOND, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:MAUREEN
Authorized Official - Last Name:MEYERS
Authorized Official - Suffix:
Authorized Official - Credentials:MHSCCCSLP
Authorized Official - Phone:219-741-4968
Mailing Address - Street 1:8616 WHEELER PL
Mailing Address - Street 2:
Mailing Address - City:CROWN POINT
Mailing Address - State:IN
Mailing Address - Zip Code:46307-8142
Mailing Address - Country:US
Mailing Address - Phone:219-741-4968
Mailing Address - Fax:219-365-2132
Practice Address - Street 1:8616 WHEELER PL
Practice Address - Street 2:
Practice Address - City:CROWN POINT
Practice Address - State:IN
Practice Address - Zip Code:46307-8142
Practice Address - Country:US
Practice Address - Phone:219-741-4968
Practice Address - Fax:219-365-2132
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN22003365A251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health