Provider Demographics
NPI:1669996328
Name:THERAPY ON DEMAND
Entity type:Organization
Organization Name:THERAPY ON DEMAND
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:
Authorized Official - Last Name:HOLLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:503-200-0944
Mailing Address - Street 1:5455 WILSHIRE BLVD STE 1010
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90036-4237
Mailing Address - Country:US
Mailing Address - Phone:503-200-0944
Mailing Address - Fax:
Practice Address - Street 1:5455 WILSHIRE BLVD STE 1010
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90036-4237
Practice Address - Country:US
Practice Address - Phone:503-200-0944
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-02
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health