Provider Demographics
NPI:1518421395
Name:IRINA'S KIDS INC
Entity Type:Organization
Organization Name:IRINA'S KIDS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ITDS
Authorized Official - Prefix:
Authorized Official - First Name:IRINA
Authorized Official - Middle Name:
Authorized Official - Last Name:TKACHEVA
Authorized Official - Suffix:
Authorized Official - Credentials:MS SPED
Authorized Official - Phone:347-217-5872
Mailing Address - Street 1:3350 NE 192ND ST # 2M-B
Mailing Address - Street 2:
Mailing Address - City:AVENTURA
Mailing Address - State:FL
Mailing Address - Zip Code:33180-2461
Mailing Address - Country:US
Mailing Address - Phone:347-217-5872
Mailing Address - Fax:347-377-8938
Practice Address - Street 1:3350 NE 192ND ST # 2M-B
Practice Address - Street 2:
Practice Address - City:AVENTURA
Practice Address - State:FL
Practice Address - Zip Code:33180-2461
Practice Address - Country:US
Practice Address - Phone:347-217-5872
Practice Address - Fax:347-377-8938
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-25
Last Update Date:2022-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes252Y00000XAgenciesEarly Intervention Provider Agency
No222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental TherapistGroup - Single Specialty