Provider Demographics
NPI:1821677790
Name:INSIGHT OT SERVICES AND CONSULTING LLC
Entity Type:Organization
Organization Name:INSIGHT OT SERVICES AND CONSULTING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING SPECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:RITA
Authorized Official - Middle Name:E
Authorized Official - Last Name:GREENE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:918-899-7375
Mailing Address - Street 1:3921 REDS GAIT LN
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32223-4053
Mailing Address - Country:US
Mailing Address - Phone:904-616-7793
Mailing Address - Fax:
Practice Address - Street 1:3921 REDS GAIT LN
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32223-4053
Practice Address - Country:US
Practice Address - Phone:904-616-7793
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-06
Last Update Date:2021-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center