Provider Demographics
NPI:1417160557
Name:ZERO 2 THREE PEDIATRIC REHAB SERVICES
Entity Type:Organization
Organization Name:ZERO 2 THREE PEDIATRIC REHAB SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER CASE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:STEFANIE
Authorized Official - Middle Name:YOUNG
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:RN ADMINISTRATOR
Authorized Official - Phone:606-305-7972
Mailing Address - Street 1:1118 HEARTLAND DRIVE
Mailing Address - Street 2:
Mailing Address - City:SOMERSET
Mailing Address - State:KY
Mailing Address - Zip Code:42503-6297
Mailing Address - Country:US
Mailing Address - Phone:606-305-7972
Mailing Address - Fax:606-678-2004
Practice Address - Street 1:1118 HEARTLAND DRIVE
Practice Address - Street 2:
Practice Address - City:SOMERSET
Practice Address - State:KY
Practice Address - Zip Code:42503-6297
Practice Address - Country:US
Practice Address - Phone:606-305-7972
Practice Address - Fax:606-678-2004
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYR3712225X00000X
KYR2191225X00000X
KY1075951251B00000X
251C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
Not Answered251B00000XAgenciesCase Management
Not Answered251C00000XAgenciesDay Training, Developmentally Disabled Services