Provider Demographics
NPI:1437605359
Name:THERAPY ZONE 4 KIDZ INCORPORATED
Entity Type:Organization
Organization Name:THERAPY ZONE 4 KIDZ INCORPORATED
Other - Org Name:THERAPY ZONE 4 KIDZ
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:NEARGARDER
Authorized Official - Suffix:
Authorized Official - Credentials:OTR
Authorized Official - Phone:408-334-0400
Mailing Address - Street 1:11705 HALE AVENUE
Mailing Address - Street 2:C-4
Mailing Address - City:MORGAN HILL
Mailing Address - State:CA
Mailing Address - Zip Code:95037-4340
Mailing Address - Country:US
Mailing Address - Phone:408-334-0400
Mailing Address - Fax:
Practice Address - Street 1:11705 HALE AVENUE
Practice Address - Street 2:C-4
Practice Address - City:MORGAN HILL
Practice Address - State:CA
Practice Address - Zip Code:95037-4340
Practice Address - Country:US
Practice Address - Phone:408-334-0400
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-31
Last Update Date:2016-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAOT1520174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty