Provider Demographics
NPI:1326210667
Name:SENSORY ZONE, LLC
Entity Type:Organization
Organization Name:SENSORY ZONE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:CAROL
Authorized Official - Middle Name:C
Authorized Official - Last Name:FIENHAGE
Authorized Official - Suffix:
Authorized Official - Credentials:OTR
Authorized Official - Phone:765-717-1903
Mailing Address - Street 1:9210 W COUNTY ROAD 500 N
Mailing Address - Street 2:
Mailing Address - City:MUNCIE
Mailing Address - State:IN
Mailing Address - Zip Code:47304-9084
Mailing Address - Country:US
Mailing Address - Phone:765-717-1903
Mailing Address - Fax:765-286-1579
Practice Address - Street 1:812 W WHITE RIVER BLVD
Practice Address - Street 2:
Practice Address - City:MUNCIE
Practice Address - State:IN
Practice Address - Zip Code:47303-3868
Practice Address - Country:US
Practice Address - Phone:765-286-1579
Practice Address - Fax:765-286-1579
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-27
Last Update Date:2008-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN32001294A224Z00000X
IN31002888A225X00000X
IN31004221A225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
No224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy AssistantGroup - Multi-Specialty