Provider Demographics
NPI:1740949478
Name:EVEREST THERAPY LLC
Entity type:Organization
Organization Name:EVEREST THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ANITA
Authorized Official - Middle Name:
Authorized Official - Last Name:TOMIC
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA
Authorized Official - Phone:727-605-1191
Mailing Address - Street 1:7121 CONGRESS ST
Mailing Address - Street 2:
Mailing Address - City:NEW PORT RICHEY
Mailing Address - State:FL
Mailing Address - Zip Code:34653-1840
Mailing Address - Country:US
Mailing Address - Phone:727-605-1191
Mailing Address - Fax:
Practice Address - Street 1:7121 CONGRESS ST
Practice Address - Street 2:
Practice Address - City:NEW PORT RICHEY
Practice Address - State:FL
Practice Address - Zip Code:34653-1840
Practice Address - Country:US
Practice Address - Phone:727-605-1191
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-09
Last Update Date:2021-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service