Provider Demographics
NPI:1679172951
Name:CHILDREN S THERAPY ZONE LLC
Entity Type:Organization
Organization Name:CHILDREN S THERAPY ZONE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPY MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:HELM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:580-830-0662
Mailing Address - Street 1:220 VILLAGE CIR
Mailing Address - Street 2:
Mailing Address - City:PONCA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:74601-4021
Mailing Address - Country:US
Mailing Address - Phone:580-830-0662
Mailing Address - Fax:
Practice Address - Street 1:220 VILLAGE CIR
Practice Address - Street 2:
Practice Address - City:PONCA CITY
Practice Address - State:OK
Practice Address - Zip Code:74601-4021
Practice Address - Country:US
Practice Address - Phone:580-830-0662
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-19
Last Update Date:2020-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
No224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy AssistantGroup - Multi-Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty