Provider Demographics
NPI:1790062719
Name:KIDS FIRST AFFILIATED SERVICES
Entity Type:Organization
Organization Name:KIDS FIRST AFFILIATED SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER/CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:JACKIE
Authorized Official - Middle Name:
Authorized Official - Last Name:CLOUSER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:814-317-5507
Mailing Address - Street 1:721 N JUNIATA ST
Mailing Address - Street 2:
Mailing Address - City:HOLLIDAYSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:16648-1455
Mailing Address - Country:US
Mailing Address - Phone:814-317-5507
Mailing Address - Fax:814-317-5522
Practice Address - Street 1:721 N JUNIATA ST
Practice Address - Street 2:
Practice Address - City:HOLLIDAYSBURG
Practice Address - State:PA
Practice Address - Zip Code:16648-1455
Practice Address - Country:US
Practice Address - Phone:814-317-5507
Practice Address - Fax:814-317-5522
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-04
Last Update Date:2023-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency