Provider Demographics
NPI:1861772972
Name:A-Z THERAPY SERVICES, INC.
Entity type:Organization
Organization Name:A-Z THERAPY SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:
Authorized Official - Last Name:GUSTAMANTES
Authorized Official - Suffix:
Authorized Official - Credentials:MOTR/L
Authorized Official - Phone:505-573-8105
Mailing Address - Street 1:701 UNSER BLVD SE STE 9
Mailing Address - Street 2:
Mailing Address - City:RIO RANCHO
Mailing Address - State:NM
Mailing Address - Zip Code:87124-6370
Mailing Address - Country:US
Mailing Address - Phone:505-892-7733
Mailing Address - Fax:505-892-9341
Practice Address - Street 1:701 UNSER BLVD SE STE 9
Practice Address - Street 2:
Practice Address - City:RIO RANCHO
Practice Address - State:NM
Practice Address - Zip Code:87124-6370
Practice Address - Country:US
Practice Address - Phone:505-892-7733
Practice Address - Fax:505-892-9341
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-19
Last Update Date:2023-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM2126261QR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation