Provider Demographics
NPI:1689819336
Name:POSITIVE SERVICES FOR KIDS, LLC
Entity Type:Organization
Organization Name:POSITIVE SERVICES FOR KIDS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:DIANE
Authorized Official - Middle Name:L
Authorized Official - Last Name:STAHNKE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:203-799-1188
Mailing Address - Street 1:1948 CHAPEL ST
Mailing Address - Street 2:
Mailing Address - City:NEW HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06515-2211
Mailing Address - Country:US
Mailing Address - Phone:203-799-1188
Mailing Address - Fax:
Practice Address - Street 1:1948 CHAPEL ST
Practice Address - Street 2:
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06515-2211
Practice Address - Country:US
Practice Address - Phone:203-799-1188
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-10
Last Update Date:2010-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251S00000XAgenciesCommunity/Behavioral HealthGroup - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No253Z00000XAgenciesIn Home Supportive Care