Provider Demographics
NPI:1568886471
Name:GREAT THERAPY GROUP LLC
Entity Type:Organization
Organization Name:GREAT THERAPY GROUP LLC
Other - Org Name:GR8 SPEECH INC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:AVIVIT
Authorized Official - Middle Name:
Authorized Official - Last Name:BEN-AHARON
Authorized Official - Suffix:
Authorized Official - Credentials:MS ED, MA CCC-SLP
Authorized Official - Phone:954-247-8757
Mailing Address - Street 1:3389 SHERIDAN ST
Mailing Address - Street 2:SUITE #113
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33021-3606
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3389 SHERIDAN ST
Practice Address - Street 2:SUITE #113
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33021-3606
Practice Address - Country:US
Practice Address - Phone:954-247-8757
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-02-12
Last Update Date:2021-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA8787235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty