Provider Demographics
NPI:1336687466
Name:THERAPLAY LEARNING CENTER, LLC
Entity Type:Organization
Organization Name:THERAPLAY LEARNING CENTER, LLC
Other - Org Name:TLC, LLC
Other - Org Type:Other Name
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:RENEE
Authorized Official - Middle Name:
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:OTR/L
Authorized Official - Phone:785-871-7987
Mailing Address - Street 1:113 N STATE ST
Mailing Address - Street 2:
Mailing Address - City:NORTON
Mailing Address - State:KS
Mailing Address - Zip Code:67654-2046
Mailing Address - Country:US
Mailing Address - Phone:785-871-7987
Mailing Address - Fax:
Practice Address - Street 1:113 N STATE ST
Practice Address - Street 2:
Practice Address - City:NORTON
Practice Address - State:KS
Practice Address - Zip Code:67654-2046
Practice Address - Country:US
Practice Address - Phone:785-871-7987
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-09
Last Update Date:2017-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS11-00568225100000X
KS17-1896225X00000X
KS17-00519225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty