Provider Demographics
NPI:1427530336
Name:ALIGN AT HOME PHYSICAL THERAPY, INC
Entity type:Organization
Organization Name:ALIGN AT HOME PHYSICAL THERAPY, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ANDREA
Authorized Official - Middle Name:SOUZA
Authorized Official - Last Name:COSTA-SHEAHAN
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:239-673-8179
Mailing Address - Street 1:504 SE 31ST TER
Mailing Address - Street 2:
Mailing Address - City:CAPE CORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33904-3472
Mailing Address - Country:US
Mailing Address - Phone:248-410-1442
Mailing Address - Fax:239-347-3914
Practice Address - Street 1:504 SE 31ST TER
Practice Address - Street 2:
Practice Address - City:CAPE CORAL
Practice Address - State:FL
Practice Address - Zip Code:33904-3472
Practice Address - Country:US
Practice Address - Phone:248-410-1442
Practice Address - Fax:239-347-3914
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-06
Last Update Date:2018-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT28137225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty