Provider Demographics
NPI:1730203811
Name:THERAPY SERVICES LLC
Entity type:Organization
Organization Name:THERAPY SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR / OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GAYLE
Authorized Official - Middle Name:M
Authorized Official - Last Name:TAYLOR-FORD
Authorized Official - Suffix:
Authorized Official - Credentials:LSCSW, LCAC
Authorized Official - Phone:620-364-2606
Mailing Address - Street 1:420 KENNEDY ST
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:KS
Mailing Address - Zip Code:66839-1120
Mailing Address - Country:US
Mailing Address - Phone:620-364-2606
Mailing Address - Fax:
Practice Address - Street 1:420 KENNEDY ST
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:KS
Practice Address - Zip Code:66839-1120
Practice Address - Country:US
Practice Address - Phone:620-364-2606
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-16
Last Update Date:2024-09-25
Deactivation Date:2008-06-06
Deactivation Code:
Reactivation Date:2008-08-19
Provider Licenses
StateLicense IDTaxonomies
101YA0400X, 1041C0700X, 343900000X
KS200373130A343900000X
KS06180761261QR0405X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)Group - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS30003878840001Medicaid
KS30003878840006Medicaid
KS30003878840002Medicaid
KS30003878840004Medicaid
KS200373130FMedicaid