Provider Demographics
NPI:1366862252
Name:LITTLE STARS CHILDREN SERVICES INC.
Entity Type:Organization
Organization Name:LITTLE STARS CHILDREN SERVICES INC.
Other - Org Name:ELSIE M
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:ELSIE
Authorized Official - Middle Name:
Authorized Official - Last Name:MONTPEROUS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-805-9572
Mailing Address - Street 1:1001 SW 191ST TER
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33029-6095
Mailing Address - Country:US
Mailing Address - Phone:305-336-1178
Mailing Address - Fax:
Practice Address - Street 1:1001 SW 191 TERRACE
Practice Address - Street 2:
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33029-6095
Practice Address - Country:US
Practice Address - Phone:305-336-1178
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-18
Last Update Date:2023-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental TherapistGroup - Single Specialty
No252Y00000XAgenciesEarly Intervention Provider AgencyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLELS777Medicaid