Provider Demographics
NPI:1922730373
Name:SENSORY ADVANTAGE, LLC
Entity Type:Organization
Organization Name:SENSORY ADVANTAGE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, CEO
Authorized Official - Prefix:
Authorized Official - First Name:JOYLYNN
Authorized Official - Middle Name:
Authorized Official - Last Name:HOLLADAY
Authorized Official - Suffix:
Authorized Official - Credentials:OTR/L
Authorized Official - Phone:773-531-3182
Mailing Address - Street 1:5222 GRACELAND AVE
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46208-2516
Mailing Address - Country:US
Mailing Address - Phone:773-531-2182
Mailing Address - Fax:
Practice Address - Street 1:1111 E 54TH ST STE 108
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46220-3580
Practice Address - Country:US
Practice Address - Phone:773-531-2182
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-25
Last Update Date:2022-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatricsGroup - Single Specialty