Provider Demographics
NPI:1710510037
Name:TRUE NORTH THERAPY SERVICES LLC
Entity Type:Organization
Organization Name:TRUE NORTH THERAPY SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OCCUPATIONAL THERAPIST
Authorized Official - Prefix:MR
Authorized Official - First Name:BRENFORD
Authorized Official - Middle Name:EDWIN
Authorized Official - Last Name:SERGENT
Authorized Official - Suffix:
Authorized Official - Credentials:OTR/L
Authorized Official - Phone:304-582-4977
Mailing Address - Street 1:653 STREET OF DREAMS
Mailing Address - Street 2:
Mailing Address - City:MARTINSBURG
Mailing Address - State:WV
Mailing Address - Zip Code:25403-1140
Mailing Address - Country:US
Mailing Address - Phone:304-582-4977
Mailing Address - Fax:
Practice Address - Street 1:653 STREET OF DREAMS
Practice Address - Street 2:
Practice Address - City:MARTINSBURG
Practice Address - State:WV
Practice Address - Zip Code:25403-1140
Practice Address - Country:US
Practice Address - Phone:304-582-4977
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-14
Last Update Date:2020-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty