Provider Demographics
NPI:1891446589
Name:KENNEDY THERAPY SERVICES, LLC
Entity Type:Organization
Organization Name:KENNEDY THERAPY SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JENNA
Authorized Official - Middle Name:M
Authorized Official - Last Name:KENNEDY
Authorized Official - Suffix:
Authorized Official - Credentials:LADC
Authorized Official - Phone:402-922-2780
Mailing Address - Street 1:510 NORRIS AVE
Mailing Address - Street 2:
Mailing Address - City:PENDER
Mailing Address - State:NE
Mailing Address - Zip Code:68047-5033
Mailing Address - Country:US
Mailing Address - Phone:402-922-2130
Mailing Address - Fax:
Practice Address - Street 1:510 NORRIS AVE
Practice Address - Street 2:
Practice Address - City:PENDER
Practice Address - State:NE
Practice Address - Zip Code:68047-5033
Practice Address - Country:US
Practice Address - Phone:402-922-2130
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-13
Last Update Date:2022-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty