Provider Demographics
NPI:1790305191
Name:ANCHORS AWAY THERAPY SERVICES, LLC
Entity Type:Organization
Organization Name:ANCHORS AWAY THERAPY SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/SPEECH LANGUAGE PATHOLOGIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:RENE
Authorized Official - Last Name:EARNEST
Authorized Official - Suffix:
Authorized Official - Credentials:MA, CCC-SLP
Authorized Official - Phone:817-718-3198
Mailing Address - Street 1:3901 RIVERWALK CT
Mailing Address - Street 2:
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34208-8052
Mailing Address - Country:US
Mailing Address - Phone:817-718-3198
Mailing Address - Fax:
Practice Address - Street 1:3901 RIVERWALK CT
Practice Address - Street 2:
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34208-8052
Practice Address - Country:US
Practice Address - Phone:817-718-3198
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-26
Last Update Date:2020-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0700XAmbulatory Health Care FacilitiesClinic/CenterHearing and Speech
No251E00000XAgenciesHome Health
No261QA3000XAmbulatory Health Care FacilitiesClinic/CenterAugmentative Communication