Provider Demographics
NPI:1831659473
Name:THE KIDDO'S CLUB LLC
Entity Type:Organization
Organization Name:THE KIDDO'S CLUB LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CEO
Authorized Official - Prefix:
Authorized Official - First Name:ARMANDO
Authorized Official - Middle Name:
Authorized Official - Last Name:ROMERO
Authorized Official - Suffix:
Authorized Official - Credentials:MS BHT
Authorized Official - Phone:520-732-3648
Mailing Address - Street 1:PO BOX 815
Mailing Address - Street 2:
Mailing Address - City:PIRTLEVILLE
Mailing Address - State:AZ
Mailing Address - Zip Code:85626-0815
Mailing Address - Country:US
Mailing Address - Phone:520-732-3648
Mailing Address - Fax:
Practice Address - Street 1:815 W FIR AVE
Practice Address - Street 2:
Practice Address - City:PIRTLEVILLE
Practice Address - State:AZ
Practice Address - Zip Code:85626-0629
Practice Address - Country:US
Practice Address - Phone:520-227-7875
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-20
Last Update Date:2023-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385H00000XRespite Care FacilityRespite Care
No251K00000XAgenciesPublic Health or Welfare
No251S00000XAgenciesCommunity/Behavioral Health
No252Y00000XAgenciesEarly Intervention Provider Agency