Provider Demographics
NPI:1972968543
Name:THERAPY SQUAD, LLC
Entity Type:Organization
Organization Name:THERAPY SQUAD, LLC
Other - Org Name:THERAPY SQUAD
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:JUVENTINO
Authorized Official - Middle Name:
Authorized Official - Last Name:RUIZ
Authorized Official - Suffix:JR
Authorized Official - Credentials:OTR
Authorized Official - Phone:956-803-0033
Mailing Address - Street 1:5215 N MCCOLL RD
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78504-2202
Mailing Address - Country:US
Mailing Address - Phone:956-803-0033
Mailing Address - Fax:956-683-6448
Practice Address - Street 1:5215 N MCCOLL RD
Practice Address - Street 2:
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78504-2202
Practice Address - Country:US
Practice Address - Phone:956-803-0033
Practice Address - Fax:956-683-6448
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-23
Last Update Date:2022-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health