Provider Demographics
NPI:1598372096
Name:THE PIECE THAT FITS DAYCARE AND ABA THERAPY, INC.
Entity Type:Organization
Organization Name:THE PIECE THAT FITS DAYCARE AND ABA THERAPY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER / CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:KRYSTLE
Authorized Official - Middle Name:
Authorized Official - Last Name:GORE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:773-571-6330
Mailing Address - Street 1:18037 RIDGEWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:LANSING
Mailing Address - State:IL
Mailing Address - Zip Code:60438-2253
Mailing Address - Country:US
Mailing Address - Phone:773-571-6330
Mailing Address - Fax:
Practice Address - Street 1:18037 RIDGEWOOD AVE
Practice Address - Street 2:
Practice Address - City:LANSING
Practice Address - State:IL
Practice Address - Zip Code:60438-2253
Practice Address - Country:US
Practice Address - Phone:773-571-6330
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-28
Last Update Date:2020-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty