Provider Demographics
NPI:1629680574
Name:KIDSABILITY THERAPY LLC
Entity Type:Organization
Organization Name:KIDSABILITY THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:KELLIE
Authorized Official - Middle Name:
Authorized Official - Last Name:ALBERTS
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:507-828-3369
Mailing Address - Street 1:PO BOX 236
Mailing Address - Street 2:
Mailing Address - City:LANGFORD
Mailing Address - State:SD
Mailing Address - Zip Code:57454-0236
Mailing Address - Country:US
Mailing Address - Phone:507-828-3369
Mailing Address - Fax:
Practice Address - Street 1:807 LINDLEY ST
Practice Address - Street 2:
Practice Address - City:LANGFORD
Practice Address - State:SD
Practice Address - Zip Code:57454
Practice Address - Country:US
Practice Address - Phone:507-828-3369
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-21
Last Update Date:2020-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes252Y00000XAgenciesEarly Intervention Provider Agency
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty