Provider Demographics
NPI:1598189292
Name:THERAPY SUPPORT SERVICES LLC
Entity Type:Organization
Organization Name:THERAPY SUPPORT SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:MYRIAM
Authorized Official - Middle Name:E
Authorized Official - Last Name:JENSEN
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:810-299-1052
Mailing Address - Street 1:5385 DEER TRL
Mailing Address - Street 2:
Mailing Address - City:LINDEN
Mailing Address - State:MI
Mailing Address - Zip Code:48451-8998
Mailing Address - Country:US
Mailing Address - Phone:810-299-1052
Mailing Address - Fax:
Practice Address - Street 1:5385 DEER TRL
Practice Address - Street 2:
Practice Address - City:LINDEN
Practice Address - State:MI
Practice Address - Zip Code:48451-8998
Practice Address - Country:US
Practice Address - Phone:810-299-1052
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:EDUCATION SUPPORT SERVICES LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-02-15
Last Update Date:2014-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty