Provider Demographics
NPI:1013683846
Name:ADAPT THERAPY LLC
Entity Type:Organization
Organization Name:ADAPT THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JARED
Authorized Official - Middle Name:AUSTIN
Authorized Official - Last Name:PURVIS
Authorized Official - Suffix:
Authorized Official - Credentials:OTR/ L
Authorized Official - Phone:208-870-3258
Mailing Address - Street 1:1886 S PELICAN AVE
Mailing Address - Street 2:
Mailing Address - City:MERIDIAN
Mailing Address - State:ID
Mailing Address - Zip Code:83642-4747
Mailing Address - Country:US
Mailing Address - Phone:208-870-3258
Mailing Address - Fax:208-795-8927
Practice Address - Street 1:3368 E GOLDSTONE DR
Practice Address - Street 2:
Practice Address - City:MERIDIAN
Practice Address - State:ID
Practice Address - Zip Code:83642-1026
Practice Address - Country:US
Practice Address - Phone:208-899-7992
Practice Address - Fax:208-795-8927
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-20
Last Update Date:2021-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatricsGroup - Multi-Specialty