Provider Demographics
NPI:1629305966
Name:ACCORD CHILDREN'S THERAPY, LLC
Entity Type:Organization
Organization Name:ACCORD CHILDREN'S THERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:DEBRA
Authorized Official - Middle Name:SMITH
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:MS, OTR
Authorized Official - Phone:812-343-2797
Mailing Address - Street 1:1397 PARIS DR
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:IN
Mailing Address - Zip Code:46131-8562
Mailing Address - Country:US
Mailing Address - Phone:812-343-2797
Mailing Address - Fax:317-738-9490
Practice Address - Street 1:1178 N MAIN ST
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:IN
Practice Address - Zip Code:46131-1251
Practice Address - Country:US
Practice Address - Phone:812-343-2797
Practice Address - Fax:317-738-9490
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-06
Last Update Date:2010-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200994570Medicaid