Provider Demographics
NPI:1477856516
Name:UNITED THERAPY SERVICES
Entity Type:Organization
Organization Name:UNITED THERAPY SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OT
Authorized Official - Prefix:MR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:LEVERENZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:563-343-4735
Mailing Address - Street 1:29 SUNNY HILL DR
Mailing Address - Street 2:
Mailing Address - City:ORION
Mailing Address - State:IL
Mailing Address - Zip Code:61273-9707
Mailing Address - Country:US
Mailing Address - Phone:309-236-4931
Mailing Address - Fax:
Practice Address - Street 1:7411 112TH ST
Practice Address - Street 2:
Practice Address - City:BLUE GRASS
Practice Address - State:IA
Practice Address - Zip Code:52726-9121
Practice Address - Country:US
Practice Address - Phone:563-563-3434
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-13
Last Update Date:2010-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL160.004296314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility