Provider Demographics
NPI:1720419930
Name:GATES THERAPY GROUP, INC.
Entity Type:Organization
Organization Name:GATES THERAPY GROUP, INC.
Other - Org Name:PLAYSTRONG PEDIATRIC THERAPY, INC.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:SARA
Authorized Official - Middle Name:
Authorized Official - Last Name:GATES
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:501-317-7994
Mailing Address - Street 1:3625 W CHESTNUT ST
Mailing Address - Street 2:
Mailing Address - City:ROGERS
Mailing Address - State:AR
Mailing Address - Zip Code:72756-0351
Mailing Address - Country:US
Mailing Address - Phone:479-246-0101
Mailing Address - Fax:479-246-0606
Practice Address - Street 1:3625 W CHESTNUT ST
Practice Address - Street 2:
Practice Address - City:ROGERS
Practice Address - State:AR
Practice Address - Zip Code:72756-0351
Practice Address - Country:US
Practice Address - Phone:479-246-0101
Practice Address - Fax:476-246-0606
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-13
Last Update Date:2017-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARPT2931261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR1952617763Medicaid
AR1487739348Medicaid