Provider Demographics
NPI:1407520596
Name:OUR SPOT FOR KIDS, LLC
Entity Type:Organization
Organization Name:OUR SPOT FOR KIDS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/OCCUPATIONAL THERAPIST
Authorized Official - Prefix:DR
Authorized Official - First Name:MANDY
Authorized Official - Middle Name:
Authorized Official - Last Name:BOWDOIN
Authorized Official - Suffix:
Authorized Official - Credentials:OTD
Authorized Official - Phone:321-412-5018
Mailing Address - Street 1:2411 19TH AVE
Mailing Address - Street 2:
Mailing Address - City:FOREST GROVE
Mailing Address - State:OR
Mailing Address - Zip Code:97116-2895
Mailing Address - Country:US
Mailing Address - Phone:321-412-5018
Mailing Address - Fax:
Practice Address - Street 1:2411 19TH AVE
Practice Address - Street 2:
Practice Address - City:FOREST GROVE
Practice Address - State:OR
Practice Address - Zip Code:97116-2895
Practice Address - Country:US
Practice Address - Phone:321-412-5018
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-03
Last Update Date:2021-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation