Provider Demographics
NPI:1760827034
Name:KIDS ABOARD THERAPY, LLC
Entity Type:Organization
Organization Name:KIDS ABOARD THERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHAYA
Authorized Official - Middle Name:GITA
Authorized Official - Last Name:POSNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-306-2807
Mailing Address - Street 1:8276 GRIFFIN RD
Mailing Address - Street 2:
Mailing Address - City:DAVIE
Mailing Address - State:FL
Mailing Address - Zip Code:33328-3715
Mailing Address - Country:US
Mailing Address - Phone:954-610-9311
Mailing Address - Fax:954-382-8453
Practice Address - Street 1:8276 GRIFFIN RD
Practice Address - Street 2:
Practice Address - City:DAVIE
Practice Address - State:FL
Practice Address - Zip Code:33328-3715
Practice Address - Country:US
Practice Address - Phone:954-306-2807
Practice Address - Fax:954-382-8453
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-01
Last Update Date:2023-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
No251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL886157900Medicaid