Provider Demographics
NPI:1467946624
Name:PLAYFUL LEARNING INTERVENTIONS LLC
Entity Type:Organization
Organization Name:PLAYFUL LEARNING INTERVENTIONS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DEVELOPMENTAL INTERVENTIONIST
Authorized Official - Prefix:MS
Authorized Official - First Name:MALLORY
Authorized Official - Middle Name:
Authorized Official - Last Name:SULLIVAN
Authorized Official - Suffix:
Authorized Official - Credentials:DI
Authorized Official - Phone:270-766-7598
Mailing Address - Street 1:1745 HAMMONSVILLE JONESVILLE RD
Mailing Address - Street 2:
Mailing Address - City:MAGNOLIA
Mailing Address - State:KY
Mailing Address - Zip Code:42757-7643
Mailing Address - Country:US
Mailing Address - Phone:270-766-7598
Mailing Address - Fax:
Practice Address - Street 1:1745 HAMMONSVILLE JONESVILLE RD
Practice Address - Street 2:
Practice Address - City:MAGNOLIA
Practice Address - State:KY
Practice Address - Zip Code:42757-7643
Practice Address - Country:US
Practice Address - Phone:270-766-7598
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-06-20
Last Update Date:2018-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency