Provider Demographics
NPI:1689878837
Name:CHILD'S PLAY FOUNDATION, INC.
Entity Type:Organization
Organization Name:CHILD'S PLAY FOUNDATION, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF SERVICES
Authorized Official - Prefix:MRS
Authorized Official - First Name:PENNY
Authorized Official - Middle Name:L
Authorized Official - Last Name:PHARES
Authorized Official - Suffix:
Authorized Official - Credentials:ARNP
Authorized Official - Phone:352-447-1775
Mailing Address - Street 1:14 HICKORY AVE
Mailing Address - Street 2:
Mailing Address - City:YANKEETOWN
Mailing Address - State:FL
Mailing Address - Zip Code:34498-2424
Mailing Address - Country:US
Mailing Address - Phone:352-447-1775
Mailing Address - Fax:352-447-2165
Practice Address - Street 1:6210 HARMONY LN
Practice Address - Street 2:
Practice Address - City:YANKEETOWN
Practice Address - State:FL
Practice Address - Zip Code:34498-2369
Practice Address - Country:US
Practice Address - Phone:352-447-1775
Practice Address - Fax:352-447-2165
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
Not Answered163WP0807XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Child & AdolescentGroup - Single Specialty