Provider Demographics
NPI:1023504529
Name:COMPLETE THERAPY, LLC
Entity type:Organization
Organization Name:COMPLETE THERAPY, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ABBY
Authorized Official - Middle Name:
Authorized Official - Last Name:LITTLE
Authorized Official - Suffix:
Authorized Official - Credentials:MOT, LOTR
Authorized Official - Phone:318-439-5329
Mailing Address - Street 1:421 AJ STEPHENS RD
Mailing Address - Street 2:
Mailing Address - City:BASKIN
Mailing Address - State:LA
Mailing Address - Zip Code:71219-9505
Mailing Address - Country:US
Mailing Address - Phone:318-439-5329
Mailing Address - Fax:
Practice Address - Street 1:421 AJ STEPHENS RD
Practice Address - Street 2:
Practice Address - City:BASKIN
Practice Address - State:LA
Practice Address - Zip Code:71219-9505
Practice Address - Country:US
Practice Address - Phone:318-439-5329
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-07-08
Last Update Date:2018-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA304387225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA2459988Medicaid