Provider Demographics
NPI:1669533105
Name:SOLACE PEDIATRIC HEALTHCARE THERAPY SERVICES AZ, INC.
Entity type:Organization
Organization Name:SOLACE PEDIATRIC HEALTHCARE THERAPY SERVICES AZ, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:REGIONAL DIRECTOR OF COMPLIANCE
Authorized Official - Prefix:
Authorized Official - First Name:LINDSAY
Authorized Official - Middle Name:
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-432-8487
Mailing Address - Street 1:60 E RIO SALADO PKWY STE 900
Mailing Address - Street 2:
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85281-9126
Mailing Address - Country:US
Mailing Address - Phone:480-456-0719
Mailing Address - Fax:480-456-0163
Practice Address - Street 1:60 E RIO SALADO PKWY STE 900
Practice Address - Street 2:
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85281-9126
Practice Address - Country:US
Practice Address - Phone:480-456-0719
Practice Address - Fax:480-456-0163
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-12
Last Update Date:2024-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty