Provider Demographics
NPI:1851062426
Name:EAT. PLAY. LOVE. OCCUPATIONAL THERAPY LLC
Entity Type:Organization
Organization Name:EAT. PLAY. LOVE. OCCUPATIONAL THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:LINDSEY
Authorized Official - Middle Name:
Authorized Official - Last Name:WOOD
Authorized Official - Suffix:
Authorized Official - Credentials:OTR/L
Authorized Official - Phone:970-380-0984
Mailing Address - Street 1:4589 WARWICK CIR
Mailing Address - Street 2:
Mailing Address - City:OCEANSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92056-4917
Mailing Address - Country:US
Mailing Address - Phone:970-380-0984
Mailing Address - Fax:
Practice Address - Street 1:4589 WARWICK CIR
Practice Address - Street 2:
Practice Address - City:OCEANSIDE
Practice Address - State:CA
Practice Address - Zip Code:92056-4917
Practice Address - Country:US
Practice Address - Phone:970-380-0984
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-23
Last Update Date:2021-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center