Provider Demographics
NPI:1982393161
Name:NURTURE THERAPY GROUP, AN OCCUPATIONAL THERAPY CORPORATION
Entity Type:Organization
Organization Name:NURTURE THERAPY GROUP, AN OCCUPATIONAL THERAPY CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OCCUPATIONAL THERAPIST, CO-OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOHAN
Authorized Official - Middle Name:
Authorized Official - Last Name:ROSS-HOLLAND
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:661-992-6262
Mailing Address - Street 1:40233 WYNGATE CT
Mailing Address - Street 2:
Mailing Address - City:PALMDALE
Mailing Address - State:CA
Mailing Address - Zip Code:93551-7538
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:848 W LANCASTER BLVD
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:CA
Practice Address - Zip Code:93534-2347
Practice Address - Country:US
Practice Address - Phone:661-992-6262
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-03
Last Update Date:2023-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty