Provider Demographics
NPI:1033236468
Name:GROSS THERAPY SERVICES, INC.
Entity Type:Organization
Organization Name:GROSS THERAPY SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE - PRESIDENT/CO-OWNER, GROSS TH
Authorized Official - Prefix:
Authorized Official - First Name:KERRI
Authorized Official - Middle Name:MELISSA
Authorized Official - Last Name:GROSS
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:870-404-9368
Mailing Address - Street 1:P.O. BOX 2398
Mailing Address - Street 2:
Mailing Address - City:MOUNTAIN HOME
Mailing Address - State:AR
Mailing Address - Zip Code:72654
Mailing Address - Country:US
Mailing Address - Phone:870-404-5299
Mailing Address - Fax:870-277-0896
Practice Address - Street 1:347 HWY 62 EAST, COLLEGE PLAZA
Practice Address - Street 2:
Practice Address - City:MOUNTAIN HOME
Practice Address - State:AR
Practice Address - Zip Code:72653
Practice Address - Country:US
Practice Address - Phone:870-701-5089
Practice Address - Fax:870-277-0896
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-22
Last Update Date:2023-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
No224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy AssistantGroup - Multi-Specialty
No225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy AssistantGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR226006742Medicaid