Provider Demographics
NPI:1902589625
Name:UNIVERSAL THERAPEUTIC SERVICES, LLC.
Entity Type:Organization
Organization Name:UNIVERSAL THERAPEUTIC SERVICES, LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:CHERYL
Authorized Official - Middle Name:L
Authorized Official - Last Name:WESTRUP
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:864-316-9109
Mailing Address - Street 1:PO BOX 8303
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29604-8303
Mailing Address - Country:US
Mailing Address - Phone:864-405-3044
Mailing Address - Fax:
Practice Address - Street 1:103 LYDIA ST
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29605-1240
Practice Address - Country:US
Practice Address - Phone:864-405-3044
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-09
Last Update Date:2023-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty