Provider Demographics
NPI:1497122063
Name:LAUGHING GIRAFFE THERAPY INC
Entity Type:Organization
Organization Name:LAUGHING GIRAFFE THERAPY INC
Other - Org Name:LAUGHING GIRAFFE THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:AARON
Authorized Official - Middle Name:RAYMOND
Authorized Official - Last Name:DENARDO
Authorized Official - Suffix:
Authorized Official - Credentials:OTR/L
Authorized Official - Phone:408-203-4090
Mailing Address - Street 1:100 OCONNOR DR STE 14
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95128-1638
Mailing Address - Country:US
Mailing Address - Phone:408-203-4090
Mailing Address - Fax:
Practice Address - Street 1:100 OCONNOR DR STE 14
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95128-1638
Practice Address - Country:US
Practice Address - Phone:408-203-4090
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-29
Last Update Date:2015-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAOT 4643261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center