Provider Demographics
NPI:1487336442
Name:DEDICATED ONSITE THERAPY LLC
Entity type:Organization
Organization Name:DEDICATED ONSITE THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CAMERON
Authorized Official - Middle Name:
Authorized Official - Last Name:MARSHALL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:408-644-7443
Mailing Address - Street 1:PO BOX 5561
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85010-5561
Mailing Address - Country:US
Mailing Address - Phone:602-224-9790
Mailing Address - Fax:
Practice Address - Street 1:4340 E INDIAN SCHOOL RD STE 21-550
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85018-9300
Practice Address - Country:US
Practice Address - Phone:408-644-7443
Practice Address - Fax:602-314-7223
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-01
Last Update Date:2023-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty