Provider Demographics
NPI:1376917880
Name:PLAY TO LEARN THERAPIES LLC
Entity Type:Organization
Organization Name:PLAY TO LEARN THERAPIES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:
Authorized Official - Last Name:GORSUCH
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA
Authorized Official - Phone:303-564-0751
Mailing Address - Street 1:1785 KEARNEY ST
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80220-1546
Mailing Address - Country:US
Mailing Address - Phone:303-564-0751
Mailing Address - Fax:
Practice Address - Street 1:1785 KEARNEY ST
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80220-1546
Practice Address - Country:US
Practice Address - Phone:303-564-0751
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-11-20
Last Update Date:2015-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
252Y00000X
CO1-15-18364103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty
Yes252Y00000XAgenciesEarly Intervention Provider Agency