Provider Demographics
NPI:1831631969
Name:ENGAGE THERAPIES, LLC
Entity type:Organization
Organization Name:ENGAGE THERAPIES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER / THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:LACEY
Authorized Official - Middle Name:N
Authorized Official - Last Name:SHOEMAKER
Authorized Official - Suffix:
Authorized Official - Credentials:CTRS
Authorized Official - Phone:254-315-7368
Mailing Address - Street 1:4636 N JOSEY LN APT 2514
Mailing Address - Street 2:
Mailing Address - City:CARROLLTON
Mailing Address - State:TX
Mailing Address - Zip Code:75010-4646
Mailing Address - Country:US
Mailing Address - Phone:254-315-7368
Mailing Address - Fax:
Practice Address - Street 1:4636 N JOSEY LN APT 2514
Practice Address - Street 2:
Practice Address - City:CARROLLTON
Practice Address - State:TX
Practice Address - Zip Code:75010-4646
Practice Address - Country:US
Practice Address - Phone:254-315-7368
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-07
Last Update Date:2016-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225800000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRecreation TherapistGroup - Single Specialty