Provider Demographics
NPI:1326654799
Name:REPLENISH THERAPY LLC
Entity Type:Organization
Organization Name:REPLENISH THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/OPERATOR
Authorized Official - Prefix:
Authorized Official - First Name:BETHANY
Authorized Official - Middle Name:
Authorized Official - Last Name:TOWNSEND
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:865-269-2570
Mailing Address - Street 1:PO BOX 9385
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37940-0385
Mailing Address - Country:US
Mailing Address - Phone:865-269-2570
Mailing Address - Fax:868-269-2558
Practice Address - Street 1:1009 E RED BUD RD
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37920-8807
Practice Address - Country:US
Practice Address - Phone:865-269-2570
Practice Address - Fax:865-269-2558
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-21
Last Update Date:2020-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty