Provider Demographics
NPI:1023244266
Name:CHILD DEVELOPMENT SERVICES SEARCH
Entity type:Organization
Organization Name:CHILD DEVELOPMENT SERVICES SEARCH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ID
Authorized Official - Middle Name:
Authorized Official - Last Name:GOSCINSKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:207-725-6365
Mailing Address - Street 1:35A GURNET ROAD
Mailing Address - Street 2:
Mailing Address - City:BRUNSWICK
Mailing Address - State:ME
Mailing Address - Zip Code:04011-2744
Mailing Address - Country:US
Mailing Address - Phone:207-725-6365
Mailing Address - Fax:207-725-4211
Practice Address - Street 1:35A GURNET ROAD
Practice Address - Street 2:
Practice Address - City:BRUNSWICK
Practice Address - State:ME
Practice Address - Zip Code:04011-2744
Practice Address - Country:US
Practice Address - Phone:207-725-6365
Practice Address - Fax:207-725-4211
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-02
Last Update Date:2009-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEPT2948261QP2000X
225X00000X, 235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
No261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical TherapyGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty