Provider Demographics
NPI:1568852499
Name:BPT SERVICES, PLLC
Entity Type:Organization
Organization Name:BPT SERVICES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DANNA
Authorized Official - Middle Name:LEIGH
Authorized Official - Last Name:BROOKS
Authorized Official - Suffix:
Authorized Official - Credentials:PT, DPT
Authorized Official - Phone:602-618-2082
Mailing Address - Street 1:PO BOX 277
Mailing Address - Street 2:
Mailing Address - City:PINE
Mailing Address - State:AZ
Mailing Address - Zip Code:85544-0277
Mailing Address - Country:US
Mailing Address - Phone:602-618-2082
Mailing Address - Fax:
Practice Address - Street 1:5138 N PINE DR
Practice Address - Street 2:
Practice Address - City:STRAWBERRY
Practice Address - State:AZ
Practice Address - Zip Code:85544
Practice Address - Country:US
Practice Address - Phone:602-618-2082
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-30
Last Update Date:2015-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ8652251C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services