Provider Demographics
NPI:1083390124
Name:E5 THERAPY INC.
Entity Type:Organization
Organization Name:E5 THERAPY INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR/BOARD PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:EILERS
Authorized Official - Last Name:DECKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:602-363-3156
Mailing Address - Street 1:333 SUNSET AVE STE 200
Mailing Address - Street 2:
Mailing Address - City:SUISUN CITY
Mailing Address - State:CA
Mailing Address - Zip Code:94585-2003
Mailing Address - Country:US
Mailing Address - Phone:707-225-7899
Mailing Address - Fax:707-759-3810
Practice Address - Street 1:410 S WARE BLVD STE 844
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33619-4469
Practice Address - Country:US
Practice Address - Phone:813-362-6788
Practice Address - Fax:813-803-7348
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:E5 THERAPY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-06-23
Last Update Date:2024-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty