Provider Demographics
NPI:1639686595
Name:OUR KINDERLACH LLC
Entity Type:Organization
Organization Name:OUR KINDERLACH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:YAELA
Authorized Official - Middle Name:
Authorized Official - Last Name:KAYKOVA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-200-4455
Mailing Address - Street 1:15010 79TH AVE APT 4H
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11367-3918
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:15010 79TH AVE APT 4H
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11367-3918
Practice Address - Country:US
Practice Address - Phone:718-200-4455
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-02
Last Update Date:2018-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY252Y00000X
252Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency