Provider Demographics
NPI:1447486865
Name:CROWLEY THERAPY GROUP
Entity type:Organization
Organization Name:CROWLEY THERAPY GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:TRACI
Authorized Official - Middle Name:H
Authorized Official - Last Name:PREJEAN
Authorized Official - Suffix:
Authorized Official - Credentials:CMM
Authorized Official - Phone:337-824-5488
Mailing Address - Street 1:1113 E NORTHERN AVE
Mailing Address - Street 2:
Mailing Address - City:CROWLEY
Mailing Address - State:LA
Mailing Address - Zip Code:70526-3035
Mailing Address - Country:US
Mailing Address - Phone:337-783-7100
Mailing Address - Fax:337-783-7104
Practice Address - Street 1:1322 ELTON RD
Practice Address - Street 2:SUITE I
Practice Address - City:JENNINGS
Practice Address - State:LA
Practice Address - Zip Code:70546-4100
Practice Address - Country:US
Practice Address - Phone:337-824-5488
Practice Address - Fax:337-824-5494
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:THIBODEAUX, ALBRO & TOUCHET THERAPY GROUP LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-06-01
Last Update Date:2023-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA5CW74Medicare UPIN