Provider Demographics
NPI:1508126210
Name:KIDS FIRST THERAPY, LLC
Entity Type:Organization
Organization Name:KIDS FIRST THERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OCCUPATIONAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:NICOLE
Authorized Official - Middle Name:
Authorized Official - Last Name:BUGIELSKI
Authorized Official - Suffix:
Authorized Official - Credentials:OTR
Authorized Official - Phone:708-612-8364
Mailing Address - Street 1:1414 WARD AVE
Mailing Address - Street 2:UNIT B
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96822-3514
Mailing Address - Country:US
Mailing Address - Phone:708-612-8364
Mailing Address - Fax:
Practice Address - Street 1:1414 WARD AVE
Practice Address - Street 2:UNIT B
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96822-3514
Practice Address - Country:US
Practice Address - Phone:708-612-8364
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-29
Last Update Date:2012-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI908261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center