Provider Demographics
NPI:1841076445
Name:AT HOME THERAPY SERVICES LLC
Entity type:Organization
Organization Name:AT HOME THERAPY SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ LCSW
Authorized Official - Prefix:MS
Authorized Official - First Name:BIANCA
Authorized Official - Middle Name:
Authorized Official - Last Name:BELL
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:651-243-0186
Mailing Address - Street 1:10756 FALLING WATER LN UNIT A
Mailing Address - Street 2:
Mailing Address - City:WOODBURY
Mailing Address - State:MN
Mailing Address - Zip Code:55129-5348
Mailing Address - Country:US
Mailing Address - Phone:701-610-3796
Mailing Address - Fax:
Practice Address - Street 1:2136 FORD PKWY # 5124
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55116-2850
Practice Address - Country:US
Practice Address - Phone:651-243-0186
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-07
Last Update Date:2023-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health