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GREAT STRIDES REHABILITATION INC. NPI 1659660157


NPI Information

NPI: 1659660157
Provider Name: GREAT STRIDES REHABILITATION, INC.
Classification: Developmental Therapist - 222Q00000X
Entity Type: Organization
Address:
12276 SAN JOSE BLVD
STE 508
JACKSONVILLE, FL
ZIP 32223
Phone: (904) 886-3228
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GREAT STRIDES REHABILITATION, INC. is a developmental therapist in Jacksonville, FL. The provider is a Developmental Therapist is a person qualified by completion of an approved program in Developmental Therapy and where applicable credentialed by the state and practicing within the scope of the credential, or credentialed by completion of education experiences as approved by the state and practicing within the scope of that credential or, where state credentialing does not exist, certified by the Board of the Developmental Therapy Association. A developmental therapist evaluates children's global development in order to identify areas of developmental delay whether arising from physiological, neurological, or environmental factors, or a combination of factors; and designs, implements, and modifies therapeutic interventions for the child and the family to promote the child's acquisition of skills in a variety of developmental areas, including cognitive processes and social interaction in order to maximize functional independence and developmental homeostasis, and improve the quality of life at home and in the community; and provides consultation for the parents and other professionals working with the family on global development. GREAT STRIDES REHABILITATION, INC. NPI is 1659660157. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

12276 SAN JOSE BLVD
STE 508
JACKSONVILLE, FL
ZIP 32223-628
Phone: (904) 886-3228
Fax: (904) 886-3297

The provider's authorized official is Jonathan Edenfield .
The authorized official title is Owner / Occupational Therapist and has the following contact phone number (904) 886-3228.

The enumeration date for this NPI number is 4/5/2011 and was last updated on 4/5/2011.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1222Q00000XDevelopmental TherapistYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1889662300MEDICAIDFLORIDA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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