Provider Demographics
NPI:1750099214
Name:B. THERAPY LLC
Entity type:Organization
Organization Name:B. THERAPY LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:VICKY
Authorized Official - Middle Name:
Authorized Official - Last Name:CHAVIS
Authorized Official - Suffix:
Authorized Official - Credentials:LPN, CWCA, CLT
Authorized Official - Phone:314-913-4690
Mailing Address - Street 1:6968 W PALO VERDE DR
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85303-4405
Mailing Address - Country:US
Mailing Address - Phone:314-913-4690
Mailing Address - Fax:
Practice Address - Street 1:4494 W PEORIA AVE STE 115A
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85302-2020
Practice Address - Country:US
Practice Address - Phone:314-440-7583
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-14
Last Update Date:2025-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center