Provider Demographics
NPI:1477878650
Name:CHILD AND FAMILY PLAY THERAPY CENTER, LLC
Entity Type:Organization
Organization Name:CHILD AND FAMILY PLAY THERAPY CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:MAXWELL
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:303-588-1897
Mailing Address - Street 1:13761 W 85TH DR
Mailing Address - Street 2:
Mailing Address - City:ARVADA
Mailing Address - State:CO
Mailing Address - Zip Code:80005-5839
Mailing Address - Country:US
Mailing Address - Phone:303-588-1897
Mailing Address - Fax:303-940-9628
Practice Address - Street 1:13761 W 85TH DR
Practice Address - Street 2:
Practice Address - City:ARVADA
Practice Address - State:CO
Practice Address - Zip Code:80005-5839
Practice Address - Country:US
Practice Address - Phone:303-588-1897
Practice Address - Fax:303-940-9628
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-31
Last Update Date:2010-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO9911291041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty