Provider Demographics
NPI:1780062711
Name:TOTALCARE THERAPIES, LLC
Entity type:Organization
Organization Name:TOTALCARE THERAPIES, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:
Authorized Official - Last Name:GROSSMAN
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:541-604-6086
Mailing Address - Street 1:20845 GREENMONT DR
Mailing Address - Street 2:
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97702-2857
Mailing Address - Country:US
Mailing Address - Phone:541-604-6086
Mailing Address - Fax:
Practice Address - Street 1:20845 GREENMONT DR
Practice Address - Street 2:
Practice Address - City:BEND
Practice Address - State:OR
Practice Address - Zip Code:97702-2857
Practice Address - Country:US
Practice Address - Phone:541-604-6086
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-11
Last Update Date:2015-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR1106622-93251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR1932586070OtherNPI # FOR COMPANY HOSPICE DIVISION