Provider Demographics
NPI:1497486575
Name:K & K THERAPEUTIC ENTERPRISES LLC
Entity Type:Organization
Organization Name:K & K THERAPEUTIC ENTERPRISES LLC
Other - Org Name:KALEIDOSCOPE KIDS PEDIATRIC THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KRISTEN
Authorized Official - Middle Name:L
Authorized Official - Last Name:BARNES
Authorized Official - Suffix:
Authorized Official - Credentials:OTR, MOT
Authorized Official - Phone:210-526-5243
Mailing Address - Street 1:5460 BABCOCK RD STE 120
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78240-3400
Mailing Address - Country:US
Mailing Address - Phone:210-526-2782
Mailing Address - Fax:210-819-5243
Practice Address - Street 1:5460 BABCOCK RD STE 120
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78240-3400
Practice Address - Country:US
Practice Address - Phone:210-526-2782
Practice Address - Fax:210-819-5243
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:K & K THERAPEUTIC ENTERPRISES LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-06-21
Last Update Date:2023-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatricsGroup - Single Specialty
No224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy AssistantGroup - Single Specialty
No2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatricsGroup - Single Specialty
No225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy AssistantGroup - Single Specialty
No2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language AssistantGroup - Single Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1497486575Medicaid