Provider Demographics
NPI:1346462066
Name:GREENWOOD THERAPY INSTITUTE
Entity Type:Organization
Organization Name:GREENWOOD THERAPY INSTITUTE
Other - Org Name:PEDIATRIC THERAPY INSTITUTE
Other - Org Type:Other Name
Authorized Official - Title/Position:OCCUPATIONAL THERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:BRENDA
Authorized Official - Middle Name:J
Authorized Official - Last Name:PARDY
Authorized Official - Suffix:
Authorized Official - Credentials:OTR
Authorized Official - Phone:303-649-9007
Mailing Address - Street 1:6535 S DAYTON ST STE 3800
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD VILLAGE
Mailing Address - State:CO
Mailing Address - Zip Code:80111-6181
Mailing Address - Country:US
Mailing Address - Phone:303-649-9007
Mailing Address - Fax:303-649-9008
Practice Address - Street 1:6535 S DAYTON ST STE 3800
Practice Address - Street 2:
Practice Address - City:GREENWOOD VILLAGE
Practice Address - State:CO
Practice Address - Zip Code:80111-6181
Practice Address - Country:US
Practice Address - Phone:303-649-9007
Practice Address - Fax:303-649-9008
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-03
Last Update Date:2008-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COAA303644174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO21053537Medicaid
CO21053537Medicaid