Provider Demographics
NPI:1225744188
Name:OT HOUSE TELEHEALTH LLC
Entity Type:Organization
Organization Name:OT HOUSE TELEHEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:J
Authorized Official - Last Name:LEFEVERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:317-910-9708
Mailing Address - Street 1:11393 HAWKSHEAD LN APT 201
Mailing Address - Street 2:
Mailing Address - City:FISHERS
Mailing Address - State:IN
Mailing Address - Zip Code:46037-4732
Mailing Address - Country:US
Mailing Address - Phone:317-910-9708
Mailing Address - Fax:
Practice Address - Street 1:1950 E GREYHOUND PASS SUITE 18
Practice Address - Street 2:211
Practice Address - City:CARMEL
Practice Address - State:IN
Practice Address - Zip Code:46033
Practice Address - Country:US
Practice Address - Phone:317-910-9708
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-24
Last Update Date:2023-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatricsGroup - Multi-Specialty
No261Q00000XAmbulatory Health Care FacilitiesClinic/CenterGroup - Multi-Specialty