Provider Demographics
NPI:1659029353
Name:OT 4 KIDZ, INC
Entity Type:Organization
Organization Name:OT 4 KIDZ, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER-DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:KARI
Authorized Official - Middle Name:
Authorized Official - Last Name:THOMPSON
Authorized Official - Suffix:
Authorized Official - Credentials:OTD, OTR/L
Authorized Official - Phone:208-957-6301
Mailing Address - Street 1:449 S. FITNESS PL.
Mailing Address - Street 2:
Mailing Address - City:EAGLE
Mailing Address - State:ID
Mailing Address - Zip Code:83616
Mailing Address - Country:US
Mailing Address - Phone:208-957-6301
Mailing Address - Fax:208-228-0585
Practice Address - Street 1:449 S. FITNESS PL.
Practice Address - Street 2:
Practice Address - City:EAGLE
Practice Address - State:ID
Practice Address - Zip Code:83616
Practice Address - Country:US
Practice Address - Phone:208-957-6301
Practice Address - Fax:208-228-0585
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:OT 4 KIDZ, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-03-13
Last Update Date:2022-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD1600XAmbulatory Health Care FacilitiesClinic/CenterDevelopmental Disabilities