Provider Demographics
NPI:1316647258
Name:583 THERAPY
Entity type:Organization
Organization Name:583 THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OCCUPATIONAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:EMILEE
Authorized Official - Middle Name:
Authorized Official - Last Name:LUEHRING
Authorized Official - Suffix:
Authorized Official - Credentials:OTR/L, CLT
Authorized Official - Phone:701-351-6274
Mailing Address - Street 1:213 5TH ST NE
Mailing Address - Street 2:
Mailing Address - City:DEVILS LAKE
Mailing Address - State:ND
Mailing Address - Zip Code:58301-2425
Mailing Address - Country:US
Mailing Address - Phone:701-662-2216
Mailing Address - Fax:
Practice Address - Street 1:213 5TH ST NE
Practice Address - Street 2:
Practice Address - City:DEVILS LAKE
Practice Address - State:ND
Practice Address - Zip Code:58301-2425
Practice Address - Country:US
Practice Address - Phone:701-662-2216
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-08
Last Update Date:2023-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation