Provider Demographics
NPI:1902968142
Name:CAPSTONE ADAPTIVE LEARNING AND THERAPY CENTERS, INC
Entity Type:Organization
Organization Name:CAPSTONE ADAPTIVE LEARNING AND THERAPY CENTERS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:SHERRY
Authorized Official - Middle Name:A
Authorized Official - Last Name:WHITE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:850-432-1596
Mailing Address - Street 1:2912 N E ST
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32501-1324
Mailing Address - Country:US
Mailing Address - Phone:850-432-1596
Mailing Address - Fax:850-432-1930
Practice Address - Street 1:2912 N E ST
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32501-1324
Practice Address - Country:US
Practice Address - Phone:850-432-1596
Practice Address - Fax:850-432-1930
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-14
Last Update Date:2014-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL811313100Medicaid
FL888221500Medicaid
FL024514396Medicaid
FL024514398Medicaid