Provider Demographics
NPI:1760643613
Name:LILY POND CHILD DEVELOPMENT CENTERS INC
Entity Type:Organization
Organization Name:LILY POND CHILD DEVELOPMENT CENTERS INC
Other - Org Name:KIDS FIRST BLAIR COUNTY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:JACQUELINE
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:CLOUSER
Authorized Official - Suffix:
Authorized Official - Credentials:MS
Authorized Official - Phone:814-943-8177
Mailing Address - Street 1:2713 W CHESTNUT AVE
Mailing Address - Street 2:
Mailing Address - City:ALTOONA
Mailing Address - State:PA
Mailing Address - Zip Code:16601-1720
Mailing Address - Country:US
Mailing Address - Phone:814-943-8177
Mailing Address - Fax:814-949-2052
Practice Address - Street 1:2713 W CHESTNUT AVE
Practice Address - Street 2:
Practice Address - City:ALTOONA
Practice Address - State:PA
Practice Address - Zip Code:16601-1720
Practice Address - Country:US
Practice Address - Phone:814-943-8177
Practice Address - Fax:814-949-2052
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-24
Last Update Date:2008-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency