Provider Demographics
NPI:1912671017
Name:CARTHAGE THERAPY LLC
Entity Type:Organization
Organization Name:CARTHAGE THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:THEODORE
Authorized Official - Last Name:ESTES
Authorized Official - Suffix:
Authorized Official - Credentials:MS
Authorized Official - Phone:417-438-4595
Mailing Address - Street 1:PO BOX 598
Mailing Address - Street 2:
Mailing Address - City:CARTHAGE
Mailing Address - State:MO
Mailing Address - Zip Code:64836-0598
Mailing Address - Country:US
Mailing Address - Phone:417-388-2185
Mailing Address - Fax:
Practice Address - Street 1:341 S MAIN ST STE 2
Practice Address - Street 2:
Practice Address - City:CARTHAGE
Practice Address - State:MO
Practice Address - Zip Code:64836-1614
Practice Address - Country:US
Practice Address - Phone:417-438-4595
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-03
Last Update Date:2021-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty