Provider Demographics
NPI:1063028033
Name:PROJECT PLAY THERAPY, LLC
Entity Type:Organization
Organization Name:PROJECT PLAY THERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO, OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KYLE
Authorized Official - Middle Name:
Authorized Official - Last Name:KEENE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-832-8955
Mailing Address - Street 1:1897 GENERAL GEORGE PATTON DR STE 108
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:TN
Mailing Address - Zip Code:37067-6232
Mailing Address - Country:US
Mailing Address - Phone:615-283-6150
Mailing Address - Fax:615-570-2846
Practice Address - Street 1:1897 GENERAL GEORGE PATTON DR STE 108
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:TN
Practice Address - Zip Code:37067-6232
Practice Address - Country:US
Practice Address - Phone:615-283-6150
Practice Address - Fax:615-570-2846
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-16
Last Update Date:2020-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty