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Contact Information

ROOSEVELT PREMIER THERAPY
1120 N EASTERN AVE STE 108
MOORE, OK73160-5856
 Phone: 405-735-7162
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Behavior Analyst

103K00000X
 

Art Therapist

221700000X
 

Developmental Therapist

222Q00000X
 

Mental Health

101YM0800X
 

Music Therapist

225A00000X
 

Nutrition, Education

133NN1002X
 

Occupational Therapist

225X00000X 67 Occupational Therapist in Private Practice
 

Physical Therapist

225100000X 65 Physical Therapist in Private Practice
 

Recreation Therapist

225800000X
 

Speech-Language Pathologist

235Z00000X 15 Speech Language Pathologist
Indicates primary specialty

NPI Profile & details for ROOSEVELT PREMIER THERAPY

NPI Number 1356188692
LBN Legal business name ROOSEVELT PREMIER THERAPY
Authorized official SELICA GRANDERSON - (DIRECTOR)
Entity Organization
Organization subpart 1 No
Enumeration date 07/12/2024
Last updated 07/15/2024 - More than a year ago
Identifiers n/a
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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