Advanced Childrens Therapy Inc

Primary specialty

Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X

Legal business name

ADVANCED CHILDRENS THERAPY INC

Practice address

2119 10TH Ave N
Lake Worth Beach, FL 33461-3345

Phone

(561) 629-6882

Fax

(561) 828-3102

NPI assigned

Aug 21, 2019

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Marlye Gonzalez Alfonso

Title

Administrator

Phone

(561) 260-1316

Specialties & licenses 5

Addresses

Other identifiers 2

Other names 1

• ADVANCED CHILDRENS THERAPY Doing business as

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1566345600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1677369600000",
    "number": "1356998637",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2119 10TH AVE N",
            "city": "LAKE WORTH BEACH",
            "state": "FL",
            "postal_code": "334613345",
            "telephone_number": "561-629-6882",
            "fax_number": "561-828-3102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2119 10TH AVE N",
            "city": "LAKE WORTH BEACH",
            "state": "FL",
            "postal_code": "334613345",
            "telephone_number": "561-629-6882",
            "fax_number": "561-828-3102"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED CHILDRENS THERAPY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-08-21",
        "last_updated": "2023-02-26",
        "certification_date": "2023-02-26",
        "status": "A",
        "authorized_official_last_name": "GONZALEZ ALFONSO",
        "authorized_official_first_name": "MARLYE",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "561-260-1316"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "252Y00000X",
            "taxonomy_group": "",
            "desc": "Early Intervention Provider Agency",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QD1600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "025094700",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "105119800",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ADVANCED CHILDRENS THERAPY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• All providers in Lake Worth Beach, FL
• Multi-Specialty Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.