Provider Demographics
NPI:1881829612
Name:KALEIDOKIDZ THERAPY, LLC
Entity Type:Organization
Organization Name:KALEIDOKIDZ THERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:DIANA
Authorized Official - Middle Name:
Authorized Official - Last Name:MARSHALL
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:972-442-9292
Mailing Address - Street 1:PO BOX 872032
Mailing Address - Street 2:
Mailing Address - City:MESQUITE
Mailing Address - State:TX
Mailing Address - Zip Code:75187-2032
Mailing Address - Country:US
Mailing Address - Phone:972-442-9292
Mailing Address - Fax:214-269-5981
Practice Address - Street 1:5507 BRADFORD ESTATES CT
Practice Address - Street 2:
Practice Address - City:SACHSE
Practice Address - State:TX
Practice Address - Zip Code:75048-3426
Practice Address - Country:US
Practice Address - Phone:972-442-9292
Practice Address - Fax:214-269-5981
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-22
Last Update Date:2009-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health