Provider Demographics
NPI:1083982136
Name:THERAPY MANAGEMENT GROUP
Entity Type:Organization
Organization Name:THERAPY MANAGEMENT GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROGRAM MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARNIE
Authorized Official - Middle Name:ANNE
Authorized Official - Last Name:LANCZ
Authorized Official - Suffix:
Authorized Official - Credentials:MED
Authorized Official - Phone:702-556-3132
Mailing Address - Street 1:6600 W CHARLESTON BLVD
Mailing Address - Street 2:SUITE 111
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89146-9001
Mailing Address - Country:US
Mailing Address - Phone:702-595-5437
Mailing Address - Fax:702-425-2787
Practice Address - Street 1:200 S VIRGINIA 8TH FLOOR
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89501
Practice Address - Country:US
Practice Address - Phone:702-595-5437
Practice Address - Fax:702-425-2787
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-05
Last Update Date:2013-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV92453251B00000X
251B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management