Maness Holding Company LLC

Primary specialty

Rehabilitation Clinic/CenterTaxonomy code 261QR0400X

Legal business name

MANESS HOLDING COMPANY LLC

Practice address

4413 NW Alsace Ave
Port Saint Lucie, FL 34983

Phone

(561) 802-8074

NPI assigned

Dec 13, 2021

Organization subpart

No

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

Authorized official

Name

Patrick Govinda Maness, MSOTNPI 1619404787

Title

Owner/Provider

Phone

(561) 802-8074

Specialties & licenses 1

Addresses

Other names 1

• Back to Life Doing business as

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Patrick Maness, MSOT

  • Occupational Therapist
  • Port Saint Lucie, FL
  • NPI 1619404787
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1639353600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1639353600000",
    "number": "1609535145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1729 NW SAINT LUCIE WEST BLVD # 1097",
            "city": "PORT SAINT LUCIE",
            "state": "FL",
            "postal_code": "349862501",
            "telephone_number": "561-802-8074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4413 NW ALSACE AVE",
            "city": "PORT SAINT LUCIE",
            "state": "FL",
            "postal_code": "34983",
            "telephone_number": "561-802-8074"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MANESS HOLDING COMPANY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-12-13",
        "last_updated": "2021-12-13",
        "certification_date": "2021-12-01",
        "status": "A",
        "authorized_official_last_name": "MANESS",
        "authorized_official_first_name": "PATRICK",
        "authorized_official_middle_name": "GOVINDA",
        "authorized_official_title_or_position": "OWNER/PROVIDER",
        "authorized_official_telephone_number": "561-802-8074",
        "authorized_official_credential": "MSOT"
    },
    "taxonomies": [
        {
            "code": "261QR0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Back to Life",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kelly Maloch, D.O.
• Laraine Ann Malone, PTA
• Bernard Habaluyas Mamuyac, LMT
• Yesenia R Mancinas Torres
• Mauricio Mandel Brigido, MD PHD
• Patrick Maness, MSOT
• Tarasue C Maness, ARNP
• Catherine Manning, APRN
• Ralph Glen Manning, LMHC
• Richard J Manson, B.S.W. , CAP

• Rehabilitation Clinic/Center in Port Saint Lucie, FL
• Providers in Port Saint Lucie, FL by specialty
• Rehabilitation Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.