1447406111 NPI number — ETHOS THERAPY SOLUTIONS, INC.

Table of content: (NPI 1447406111)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1447406111 NPI number — ETHOS THERAPY SOLUTIONS, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ETHOS THERAPY SOLUTIONS, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1447406111
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/23/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
785 ARBOR WAY STE 1N
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BLUE BELL
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
19422-1986
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
888-861-8612
Provider Business Mailing Address Fax Number:
844-533-0601

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
785 ARBOR WAY STE 1N
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BLUE BELL
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19422-1986
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
888-861-8612
Provider Business Practice Location Address Fax Number:
844-533-0601
Provider Enumeration Date:
08/13/2008

Additional Information

Authorized Official

Authorized Official Last Name:
BYRNE
Authorized Official First Name:
MICHAEL
Authorized Official Middle Name:
Authorized Official Title or Position:
VICE PRESIDENT
Authorized Official Telephone Number:
800-861-8612

Provider Taxonomy Codes

  • Taxonomy code: 332BC3200X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 332B00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 106013000 . This is a "Florida Medicaid Provider ID" identifier , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".




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