Provider Demographics
NPI:1740367747
Name:SWEET SPRINGS THERAPY CENTER INC
Entity type:Organization
Organization Name:SWEET SPRINGS THERAPY CENTER INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:SHIRLEY
Authorized Official - Middle Name:ROMARATE
Authorized Official - Last Name:SUMILANG
Authorized Official - Suffix:
Authorized Official - Credentials:RPT
Authorized Official - Phone:660-335-4431
Mailing Address - Street 1:PO BOX 45
Mailing Address - Street 2:718 BRIDGE STREET
Mailing Address - City:SWEET SPRINGS
Mailing Address - State:MO
Mailing Address - Zip Code:65351
Mailing Address - Country:US
Mailing Address - Phone:660-335-4431
Mailing Address - Fax:660-335-4134
Practice Address - Street 1:718 BRIDGE STREET
Practice Address - Street 2:
Practice Address - City:SWEET SPRINGS
Practice Address - State:MO
Practice Address - Zip Code:65351
Practice Address - Country:US
Practice Address - Phone:660-335-4431
Practice Address - Fax:660-335-4134
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
35640019OtherCTC BCBS OF KC GROUP
40284OtherBTC HEALTHCARE USA
21182036OtherCTC BCBS OF KC INDIV
35641017OtherMTC BCBS OF KC GROUP
35644011OtherBTC BCBS OF KC GROUP
21182026OtherSSTC BCBS OF KC INDIV
21182056OtherBTC BCBS OF KC INDIV
40282OtherCTC HEALTHCARE USA
21491034OtherSSTC BCBS OF KC GROUP
40285OtherMTC HEALTHCARE USA
9368OtherSSTC HEALTHCARE USA
21182046OtherMTC BCBS OF KC INDIV
35644011OtherBTC BCBS OF KC GROUP