Provider Demographics
NPI:1538628003
Name:HOLSMAN CHILDREN'S THERAPY CENTER LLC
Entity type:Organization
Organization Name:HOLSMAN CHILDREN'S THERAPY CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:
Authorized Official - Last Name:HOLSMAN
Authorized Official - Suffix:
Authorized Official - Credentials:PT, DPT, GCS
Authorized Official - Phone:973-393-5545
Mailing Address - Street 1:710 MILL ST UNIT H3
Mailing Address - Street 2:
Mailing Address - City:BELLEVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:07109-5306
Mailing Address - Country:US
Mailing Address - Phone:973-759-1494
Mailing Address - Fax:973-759-0557
Practice Address - Street 1:15-01 BROADWAY STE 14C
Practice Address - Street 2:
Practice Address - City:FAIR LAWN
Practice Address - State:NJ
Practice Address - Zip Code:07410-6018
Practice Address - Country:US
Practice Address - Phone:201-351-1682
Practice Address - Fax:732-428-5513
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-14
Last Update Date:2019-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251S00000XAgenciesCommunity/Behavioral Health
No103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ41YS00629500OtherNJ DIVISION OF CONSUMER AFFAIRS