Provider Demographics
NPI:1689915795
Name:TOTAL CHILD THERAPY HOME HEALTH PLLC
Entity Type:Organization
Organization Name:TOTAL CHILD THERAPY HOME HEALTH PLLC
Other - Org Name:TOTAL CHILD THERAPY HOME HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:EMYLIE
Authorized Official - Middle Name:
Authorized Official - Last Name:SHINTO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:512-504-3035
Mailing Address - Street 1:407 S OLD HIGHWAY 81
Mailing Address - Street 2:
Mailing Address - City:KYLE
Mailing Address - State:TX
Mailing Address - Zip Code:78640-5310
Mailing Address - Country:US
Mailing Address - Phone:512-504-3035
Mailing Address - Fax:521-504-9287
Practice Address - Street 1:407 S OLD HIGHWAY 81
Practice Address - Street 2:
Practice Address - City:KYLE
Practice Address - State:TX
Practice Address - Zip Code:78640-5310
Practice Address - Country:US
Practice Address - Phone:512-504-3035
Practice Address - Fax:521-504-9287
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-14
Last Update Date:2013-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health