Provider Demographics
NPI:1407912108
Name:OUR KIDZ COUNT, LLC
Entity Type:Organization
Organization Name:OUR KIDZ COUNT, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST, AND CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:NICOLE
Authorized Official - Middle Name:RENEE
Authorized Official - Last Name:STUDEVAN
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:404-358-7836
Mailing Address - Street 1:1698 FONTAINE DR
Mailing Address - Street 2:
Mailing Address - City:JONESBORO
Mailing Address - State:GA
Mailing Address - Zip Code:30236-3322
Mailing Address - Country:US
Mailing Address - Phone:404-358-7836
Mailing Address - Fax:770-478-8448
Practice Address - Street 1:1698 FONTAINE DR
Practice Address - Street 2:
Practice Address - City:JONESBORO
Practice Address - State:GA
Practice Address - Zip Code:30236-3322
Practice Address - Country:US
Practice Address - Phone:404-358-7836
Practice Address - Fax:770-478-8448
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPT006746251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health