Organization
THE ACCOMMODATION STATION, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALEXANDRA DANTEC OTR/L (OWNER)
(917) 502-8871
Entity
Organization
Contact information
Practice address
515 COLLEGE RD STE 14, GREENSBORO, NC 27410-5150
(917) 502-8871
Mailing address
5939 W FRIENDLY AVE APT 26L, GREENSBORO, NC 27410-3351
(917) 502-8871
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
11187
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1104183912
—
NY
Enumeration date
08/31/2018
Last updated
08/31/2018
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