Provider Demographics
NPI:1457505935
Name:FOR THE KIDS SERVICES
Entity Type:Organization
Organization Name:FOR THE KIDS SERVICES
Other - Org Name:FTK SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ONTWAIN
Authorized Official - Middle Name:
Authorized Official - Last Name:SIMPSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:803-207-9805
Mailing Address - Street 1:4746 CASCADE AVE
Mailing Address - Street 2:
Mailing Address - City:ROCK HILL
Mailing Address - State:SC
Mailing Address - Zip Code:29732-8190
Mailing Address - Country:US
Mailing Address - Phone:803-207-9805
Mailing Address - Fax:
Practice Address - Street 1:4746 CASCADE AVE
Practice Address - Street 2:
Practice Address - City:ROCK HILL
Practice Address - State:SC
Practice Address - Zip Code:29732-8190
Practice Address - Country:US
Practice Address - Phone:803-207-9805
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-10
Last Update Date:2011-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA-5388253Z00000X
SCRCP 3381253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care