Provider Demographics
NPI:1386400547
Name:CONNECTED HEALTH THERAPIES LLC
Entity type:Organization
Organization Name:CONNECTED HEALTH THERAPIES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ORGANIZER
Authorized Official - Prefix:
Authorized Official - First Name:DEREK
Authorized Official - Middle Name:
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:PT, DPT
Authorized Official - Phone:870-351-4591
Mailing Address - Street 1:PO BOX 183
Mailing Address - Street 2:
Mailing Address - City:CUSHMAN
Mailing Address - State:AR
Mailing Address - Zip Code:72526-0183
Mailing Address - Country:US
Mailing Address - Phone:870-351-4591
Mailing Address - Fax:
Practice Address - Street 1:40 NORTH MAIN STREET
Practice Address - Street 2:
Practice Address - City:CUSHMAN
Practice Address - State:AR
Practice Address - Zip Code:72526
Practice Address - Country:US
Practice Address - Phone:870-613-3641
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-26
Last Update Date:2024-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty