Provider Demographics
NPI:1326770835
Name:ALTRU THERAPY, LLC
Entity Type:Organization
Organization Name:ALTRU THERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:C
Authorized Official - Last Name:KAHLBAUGH
Authorized Official - Suffix:
Authorized Official - Credentials:OT
Authorized Official - Phone:480-205-6917
Mailing Address - Street 1:9357 E PRINCESS DR
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85207-4316
Mailing Address - Country:US
Mailing Address - Phone:480-205-6917
Mailing Address - Fax:
Practice Address - Street 1:9357 E PRINCESS DR
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85207-4316
Practice Address - Country:US
Practice Address - Phone:480-205-6917
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-24
Last Update Date:2022-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health