Provider Demographics
NPI:1336902998
Name:BRAINSTORM THERAPY SERVICES LLC
Entity type:Organization
Organization Name:BRAINSTORM THERAPY SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NATALIE
Authorized Official - Middle Name:
Authorized Official - Last Name:BOWMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:309-825-5082
Mailing Address - Street 1:864 S LEWIS ST
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80226-3926
Mailing Address - Country:US
Mailing Address - Phone:309-825-5082
Mailing Address - Fax:
Practice Address - Street 1:393 S HARLAN ST STE 108
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80226-3569
Practice Address - Country:US
Practice Address - Phone:309-825-5082
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BRAINSTORM THERAPY SERVICES LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-02-05
Last Update Date:2024-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QH0700XAmbulatory Health Care FacilitiesClinic/CenterHearing and Speech
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty