Provider Demographics
NPI:1568798544
Name:KIDS CHOICE LLC
Entity Type:Organization
Organization Name:KIDS CHOICE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:MRS
Authorized Official - First Name:DEANDRA
Authorized Official - Middle Name:L
Authorized Official - Last Name:DEMES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:330-550-3003
Mailing Address - Street 1:2890 SE RIVER RD
Mailing Address - Street 2:
Mailing Address - City:BERLIN CENTER
Mailing Address - State:OH
Mailing Address - Zip Code:44401-9779
Mailing Address - Country:US
Mailing Address - Phone:330-550-3003
Mailing Address - Fax:
Practice Address - Street 1:8561 MARKET ST
Practice Address - Street 2:
Practice Address - City:BOARDMAN
Practice Address - State:OH
Practice Address - Zip Code:44512-6727
Practice Address - Country:US
Practice Address - Phone:330-953-2383
Practice Address - Fax:330-953-2384
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-26
Last Update Date:2023-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
225X00000X
OHSP9491235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty