Provider Demographics
NPI:1629228242
Name:KIDS THERAPLAY, INC.
Entity Type:Organization
Organization Name:KIDS THERAPLAY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:KOLLIN
Authorized Official - Middle Name:ASHLEY
Authorized Official - Last Name:SOTOLONGO
Authorized Official - Suffix:
Authorized Official - Credentials:MSOTR
Authorized Official - Phone:317-201-0446
Mailing Address - Street 1:11133 COWAN LAKE CT
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46235-6846
Mailing Address - Country:US
Mailing Address - Phone:317-201-0446
Mailing Address - Fax:317-855-7450
Practice Address - Street 1:11133 COWAN LAKE CT
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46235-6846
Practice Address - Country:US
Practice Address - Phone:317-201-0446
Practice Address - Fax:317-855-7450
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-19
Last Update Date:2008-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN31004419A252Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency