Provider Demographics
NPI:1518208966
Name:LEARNING GARDEN DEVELOPMENTAL PRESCHOOL
Entity Type:Organization
Organization Name:LEARNING GARDEN DEVELOPMENTAL PRESCHOOL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:CATHLEEN
Authorized Official - Middle Name:M
Authorized Official - Last Name:KOWALSKI
Authorized Official - Suffix:
Authorized Official - Credentials:MED
Authorized Official - Phone:208-777-2629
Mailing Address - Street 1:412 E MULLAN AVE
Mailing Address - Street 2:
Mailing Address - City:POST FALLS
Mailing Address - State:ID
Mailing Address - Zip Code:83854-7641
Mailing Address - Country:US
Mailing Address - Phone:208-777-2629
Mailing Address - Fax:
Practice Address - Street 1:412 E MULLAN AVE
Practice Address - Street 2:
Practice Address - City:POST FALLS
Practice Address - State:ID
Practice Address - Zip Code:83854-7641
Practice Address - Country:US
Practice Address - Phone:208-777-2629
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-11
Last Update Date:2013-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDDDA4638251C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services