Provider Demographics
NPI:1295206407
Name:THE PLAY SKOOL LLC
Entity Type:Organization
Organization Name:THE PLAY SKOOL LLC
Other - Org Name:THE PLAY SKOOL LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JENAE
Authorized Official - Middle Name:
Authorized Official - Last Name:WATERFIELD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:424-262-5868
Mailing Address - Street 1:21515 HAWTHORNE BLVD STE 200
Mailing Address - Street 2:
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90503-6512
Mailing Address - Country:US
Mailing Address - Phone:424-262-5868
Mailing Address - Fax:424-256-3176
Practice Address - Street 1:21515 HAWTHORNE BLVD STE 200
Practice Address - Street 2:
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90503-6512
Practice Address - Country:US
Practice Address - Phone:424-262-5868
Practice Address - Fax:424-256-3176
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-12-16
Last Update Date:2018-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty