Provider Demographics
NPI:1548978117
Name:NURTURE PEDIATRIC THERAPY LLC
Entity type:Organization
Organization Name:NURTURE PEDIATRIC THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ALLISON
Authorized Official - Middle Name:ANNE
Authorized Official - Last Name:PASCARELLA
Authorized Official - Suffix:
Authorized Official - Credentials:MA, CCC-SLP
Authorized Official - Phone:574-807-1456
Mailing Address - Street 1:60610 FIR RD
Mailing Address - Street 2:
Mailing Address - City:MISHAWAKA
Mailing Address - State:IN
Mailing Address - Zip Code:46544-9216
Mailing Address - Country:US
Mailing Address - Phone:574-807-1456
Mailing Address - Fax:574-807-9598
Practice Address - Street 1:928 S MERRIFIELD AVE
Practice Address - Street 2:
Practice Address - City:MISHAWAKA
Practice Address - State:IN
Practice Address - Zip Code:46544-2807
Practice Address - Country:US
Practice Address - Phone:574-807-1456
Practice Address - Fax:574-807-9598
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-11
Last Update Date:2022-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center