Healthcare Provider Details
I. General information
NPI: 1316647258
Provider Name (Legal Business Name): 583 THERAPY
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/08/2023
Last Update Date: 08/25/2025
Certification Date: 08/25/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
213 5TH ST NE
DEVILS LAKE ND
58301-2425
US
IV. Provider business mailing address
213 5TH ST NE
DEVILS LAKE ND
58301-2425
US
V. Phone/Fax
- Phone: 701-662-2216
- Fax:
- Phone: 701-662-2216
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QR0400X |
| Taxonomy | Rehabilitation Clinic/Center |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 235Z00000X |
| Taxonomy | Speech-Language Pathologist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
EMILEE
LUEHRING
Title or Position: OCCUPATIONAL THERAPIST
Credential: OTR/L, CLT
Phone: 701-351-6274