Provider Demographics
NPI:1588417273
Name:GRAND THERAPY LTD
Entity type:Organization
Organization Name:GRAND THERAPY LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING
Authorized Official - Prefix:
Authorized Official - First Name:BETH
Authorized Official - Middle Name:
Authorized Official - Last Name:TIMPSON-SCHLEEPER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:602-246-0721
Mailing Address - Street 1:5122 W SWAYBACK PASS
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85083-4440
Mailing Address - Country:US
Mailing Address - Phone:602-246-0721
Mailing Address - Fax:602-246-0720
Practice Address - Street 1:3420 E SHEA BLVD STE 209
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85028-3345
Practice Address - Country:US
Practice Address - Phone:630-888-7729
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-10
Last Update Date:2024-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0700XAmbulatory Health Care FacilitiesClinic/CenterHearing and Speech