Provider Demographics
NPI:1750136172
Name:COLLABORATIVE THERAPIES LLC
Entity type:Organization
Organization Name:COLLABORATIVE THERAPIES LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MGR/ OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:TIYE
Authorized Official - Middle Name:
Authorized Official - Last Name:HUERTAS
Authorized Official - Suffix:
Authorized Official - Credentials:MA CCC-SLP
Authorized Official - Phone:407-619-5988
Mailing Address - Street 1:PO BOX 541743
Mailing Address - Street 2:
Mailing Address - City:MERRITT ISLAND
Mailing Address - State:FL
Mailing Address - Zip Code:32954-1743
Mailing Address - Country:US
Mailing Address - Phone:407-619-5988
Mailing Address - Fax:
Practice Address - Street 1:7480 ALOMA AVE
Practice Address - Street 2:
Practice Address - City:WINTER PARK
Practice Address - State:FL
Practice Address - Zip Code:32792-9102
Practice Address - Country:US
Practice Address - Phone:321-587-1375
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-19
Last Update Date:2024-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251E00000XAgenciesHome Health
No224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy AssistantGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
No253Z00000XAgenciesIn Home Supportive CareGroup - Multi-Specialty
No385H00000XRespite Care FacilityRespite CareGroup - Multi-Specialty
No252Y00000XAgenciesEarly Intervention Provider Agency