Provider Demographics
NPI:1760265359
Name:AMANI THERAPY SERVICES LLC
Entity Type:Organization
Organization Name:AMANI THERAPY SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:M
Authorized Official - Last Name:NABEA
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:808-495-1211
Mailing Address - Street 1:2989 WOODLAND ASH CV
Mailing Address - Street 2:
Mailing Address - City:LAKELAND
Mailing Address - State:TN
Mailing Address - Zip Code:38002-3834
Mailing Address - Country:US
Mailing Address - Phone:808-224-7954
Mailing Address - Fax:
Practice Address - Street 1:2989 WOODLAND ASH CV
Practice Address - Street 2:
Practice Address - City:LAKELAND
Practice Address - State:TN
Practice Address - Zip Code:38002-3834
Practice Address - Country:US
Practice Address - Phone:808-224-7954
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-16
Last Update Date:2023-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty