# MOBILE THERAPY CENTER OF AMERICA, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1225064488
- **Authorized official:** JASON NEWMAN (OWNER)
- **Authorized official phone:** (224) 354-1290

## Contact information

- **Practice address:** 854 TECHNOLOGY WAY, LIBERTYVILLE, IL 60048-5350
- **Practice address phone:** (847) 816-7200
- **Practice address fax:** (847) 816-7210
- **Mailing address:** 854 TECHNOLOGY WAY, LIBERTYVILLE, IL 60048-5350
- **Mailing address phone:** (847) 816-7200
- **Mailing address fax:** (847) 816-7210

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1041C0700X | Clinical Social Worker | — | NULL | — |
| 1041C0700X | Clinical Social Worker | — | — | — |
| 225100000X | Physical Therapist | — | NULL | — |
| 225100000X | Physical Therapist | — | — | — |
| 225X00000X | Occupational Therapist | — | NULL | — |
| 225X00000X | Occupational Therapist | — | — | — |
| 235Z00000X | Speech-Language Pathologist | — | NULL | — |
| 235Z00000X | Speech-Language Pathologist | — | — | — |
| 261QM1300X | Multi-Specialty Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 06/22/2006
- **Last updated:** 12/27/2023