Provider Demographics
NPI:1205985132
Name:ALL COAST THERAPY SERVICES, INC.
Entity type:Organization
Organization Name:ALL COAST THERAPY SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:BEULAH
Authorized Official - Middle Name:EK
Authorized Official - Last Name:SCOTT
Authorized Official - Suffix:
Authorized Official - Credentials:OT
Authorized Official - Phone:352-751-1095
Mailing Address - Street 1:13940 N US HIGHWAY 441
Mailing Address - Street 2:BUILDING 600, SUITE 603
Mailing Address - City:LADY LAKE
Mailing Address - State:FL
Mailing Address - Zip Code:32159-8953
Mailing Address - Country:US
Mailing Address - Phone:352-751-1095
Mailing Address - Fax:352-751-1097
Practice Address - Street 1:13940 N US HIGHWAY 441
Practice Address - Street 2:BUILDING 600 SUITE 603
Practice Address - City:LADY LAKE
Practice Address - State:FL
Practice Address - Zip Code:32159-8953
Practice Address - Country:US
Practice Address - Phone:352-751-1095
Practice Address - Fax:352-751-1097
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-09
Last Update Date:2008-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL299992295251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL108268Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER