Provider Demographics
NPI:1558038315
Name:SKUPA THERAPY LLC
Entity Type:Organization
Organization Name:SKUPA THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:IRENA
Authorized Official - Middle Name:
Authorized Official - Last Name:STJEPIC
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-496-6040
Mailing Address - Street 1:8173 COLEY DAVIS RD
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37221-2313
Mailing Address - Country:US
Mailing Address - Phone:615-496-6040
Mailing Address - Fax:
Practice Address - Street 1:4205 HILLSBORO PIKE STE 312
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37215-3339
Practice Address - Country:US
Practice Address - Phone:615-496-6040
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-27
Last Update Date:2021-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1235310210OtherNPI