| Organization Name: | THERAPY CONNECTION OF THE TREASURE COAST |
| NPI Number: | 1124486949 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | JUSTINE THEISEN (OWNER) |
| Mailing Address: | 5811 Bamboo Dr Fort Pierce |
| State: | FL US |
| Postal Code: | 349823758 |
| Phone Number: | 7722423187 |
| Fax Number: | 7724947262 |
| NPI Enumeration Date: | 02/08/2016 |
| NPI Last Update Date: | 06/10/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 251K00000X |
| License Number: | SA10918 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| Taxonomy Type: | Agencies |
| Taxonomy Classification: | Public Health or Welfare |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |