Provider Demographics
NPI:1790490985
Name:ATHOME THERAPY SOLUTIONS - CENTRAL LLC
Entity Type:Organization
Organization Name:ATHOME THERAPY SOLUTIONS - CENTRAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:FROILAN
Authorized Official - Middle Name:
Authorized Official - Last Name:MOGOL
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:973-393-6197
Mailing Address - Street 1:94 ATHENIA AVE
Mailing Address - Street 2:
Mailing Address - City:CLIFTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07013-2639
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:94 ATHENIA AVE
Practice Address - Street 2:
Practice Address - City:CLIFTON
Practice Address - State:NJ
Practice Address - Zip Code:07013-2639
Practice Address - Country:US
Practice Address - Phone:973-393-6197
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-23
Last Update Date:2023-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty