Provider Demographics
NPI:1093566754
Name:TUMBLE TOTS ARIZONA
Entity Type:Organization
Organization Name:TUMBLE TOTS ARIZONA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CARISSA
Authorized Official - Middle Name:A
Authorized Official - Last Name:CARILLO
Authorized Official - Suffix:
Authorized Official - Credentials:COTA/L
Authorized Official - Phone:520-599-3807
Mailing Address - Street 1:300 E CAMINO DEL PINSAPO
Mailing Address - Street 2:
Mailing Address - City:SAHUARITA
Mailing Address - State:AZ
Mailing Address - Zip Code:85629-8739
Mailing Address - Country:US
Mailing Address - Phone:520-599-3807
Mailing Address - Fax:
Practice Address - Street 1:300 E CAMINO DEL PINSAPO
Practice Address - Street 2:
Practice Address - City:SAHUARITA
Practice Address - State:AZ
Practice Address - Zip Code:85629-8739
Practice Address - Country:US
Practice Address - Phone:520-599-3807
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-01
Last Update Date:2024-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatricsGroup - Single Specialty