Provider Demographics
NPI:1851157648
Name:RANCOUR THERAPY LLC
Entity Type:Organization
Organization Name:RANCOUR THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LIESL
Authorized Official - Middle Name:
Authorized Official - Last Name:RANCOUR
Authorized Official - Suffix:
Authorized Official - Credentials:OTR/L
Authorized Official - Phone:585-760-9276
Mailing Address - Street 1:1490 N WALES RD
Mailing Address - Street 2:
Mailing Address - City:BLUE BELL
Mailing Address - State:PA
Mailing Address - Zip Code:19422-3687
Mailing Address - Country:US
Mailing Address - Phone:585-760-9276
Mailing Address - Fax:
Practice Address - Street 1:1490 N WALES RD
Practice Address - Street 2:
Practice Address - City:BLUE BELL
Practice Address - State:PA
Practice Address - Zip Code:19422-3687
Practice Address - Country:US
Practice Address - Phone:585-760-9276
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-28
Last Update Date:2024-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency