Provider Demographics
NPI:1730416777
Name:CASTLE THERAPY, LLC
Entity type:Organization
Organization Name:CASTLE THERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER MGRM
Authorized Official - Prefix:MRS
Authorized Official - First Name:REMAI
Authorized Official - Middle Name:JACQUELINE
Authorized Official - Last Name:ECKHARDT
Authorized Official - Suffix:
Authorized Official - Credentials:MS, CCC-SLP
Authorized Official - Phone:561-747-8188
Mailing Address - Street 1:8825 SE LONGVIEW DR
Mailing Address - Street 2:
Mailing Address - City:HOBE SOUND
Mailing Address - State:FL
Mailing Address - Zip Code:33455-7420
Mailing Address - Country:US
Mailing Address - Phone:561-747-8188
Mailing Address - Fax:561-747-8388
Practice Address - Street 1:169 TEQUESTA DR
Practice Address - Street 2:SUITE 24 E
Practice Address - City:TEQUESTA
Practice Address - State:FL
Practice Address - Zip Code:33469-2768
Practice Address - Country:US
Practice Address - Phone:561-747-8188
Practice Address - Fax:561-747-8388
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-12
Last Update Date:2012-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLZ125C225X00000X
2355S0801X, 235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
No2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language AssistantGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL001691600Medicaid
FL001691900Medicaid
FL002240900Medicaid
S9401OtherBCBS
FLSA7527OtherSTATE
FL001691601Medicaid
FL002891400Medicaid
FL891720500Medicaid
FL892241100Medicaid
12009739OtherASHA
FLY90C2OtherBCBS