Provider Demographics
NPI:1811383409
Name:KIDZ CHOICE SERVICES, INC.
Entity Type:Organization
Organization Name:KIDZ CHOICE SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:LAFASAKIS
Authorized Official - Suffix:
Authorized Official - Credentials:MS ED, LBA/BCBA-D
Authorized Official - Phone:718-569-5439
Mailing Address - Street 1:1434 110TH ST STE 303
Mailing Address - Street 2:
Mailing Address - City:COLLEGE POINT
Mailing Address - State:NY
Mailing Address - Zip Code:11356-1448
Mailing Address - Country:US
Mailing Address - Phone:718-569-5439
Mailing Address - Fax:718-569-5439
Practice Address - Street 1:1434 110TH ST STE 303
Practice Address - Street 2:
Practice Address - City:COLLEGE POINT
Practice Address - State:NY
Practice Address - Zip Code:11356-1448
Practice Address - Country:US
Practice Address - Phone:718-569-5439
Practice Address - Fax:718-569-5439
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-09
Last Update Date:2020-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty