Provider Demographics
NPI:1205267044
Name:JOES KIDS INC
Entity type:Organization
Organization Name:JOES KIDS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:LYNNE
Authorized Official - Last Name:BAZZONI
Authorized Official - Suffix:
Authorized Official - Credentials:MS,PT
Authorized Official - Phone:574-376-2316
Mailing Address - Street 1:1692 W LAKE ST
Mailing Address - Street 2:
Mailing Address - City:WARSAW
Mailing Address - State:IN
Mailing Address - Zip Code:46580-2494
Mailing Address - Country:US
Mailing Address - Phone:574-306-4589
Mailing Address - Fax:574-306-2208
Practice Address - Street 1:1692 W LAKE ST
Practice Address - Street 2:
Practice Address - City:WARSAW
Practice Address - State:IN
Practice Address - Zip Code:46580-2494
Practice Address - Country:US
Practice Address - Phone:574-376-2316
Practice Address - Fax:574-306-2208
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-04
Last Update Date:2024-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty