Provider Demographics
NPI: | 1962964130 |
---|---|
Name: | HERO THERAPY LLC |
Entity type: | Organization |
Organization Name: | HERO THERAPY LLC |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | PARTNER/OCCUPATIONAL THERAPIST |
Authorized Official - Prefix: | MR |
Authorized Official - First Name: | OUTHAI |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | SAENGKHEUNE |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | OTR/L |
Authorized Official - Phone: | 978-870-6935 |
Mailing Address - Street 1: | 435 LANCASTER ST STE 341D |
Mailing Address - Street 2: | |
Mailing Address - City: | LEOMINSTER |
Mailing Address - State: | MA |
Mailing Address - Zip Code: | 01453-4397 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 978-870-6935 |
Mailing Address - Fax: | 833-391-6677 |
Practice Address - Street 1: | 435 LANCASTER ST STE 341D |
Practice Address - Street 2: | |
Practice Address - City: | LEOMINSTER |
Practice Address - State: | MA |
Practice Address - Zip Code: | 01453-4397 |
Practice Address - Country: | US |
Practice Address - Phone: | 978-870-6935 |
Practice Address - Fax: | 833-391-6677 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2019-04-04 |
Last Update Date: | 2023-07-11 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 225100000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | Group - Multi-Specialty | |
No | 103K00000X | Behavioral Health & Social Service Providers | Behavior Analyst | Group - Multi-Specialty | |
No | 104100000X | Behavioral Health & Social Service Providers | Social Worker | Group - Multi-Specialty | |
No | 183500000X | Pharmacy Service Providers | Pharmacist | Group - Multi-Specialty | |
No | 224Z00000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapy Assistant | Group - Multi-Specialty | |
No | 225200000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapy Assistant | Group - Multi-Specialty | |
No | 225X00000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist | Group - Multi-Specialty | |
No | 227900000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Respiratory Therapist, Registered | Group - Multi-Specialty | |
No | 235Z00000X | Speech, Language and Hearing Service Providers | Speech-Language Pathologist | Group - Multi-Specialty | |
No | 251E00000X | Agencies | Home Health | Group - Multi-Specialty |