Organization
THERAFUN LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MATTHEW BREWER (OWNER OTR/L)
(417) 459-6441
Entity
Organization
Contact information
Practice address
435 N GREGG RD, NIXA, MO 65714-9037
(417) 459-6441
Mailing address
435 N GREGG RD, NIXA, MO 65714-9037
(417) 459-6441
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
—
—
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
—
—
Other
Enumeration date
07/09/2020
Last updated
11/18/2025
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