Provider Demographics
NPI:1245691096
Name:PIECE OF OUR PUZZLE LLC
Entity type:Organization
Organization Name:PIECE OF OUR PUZZLE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED BEHAVIORAL SPECIALIST, ABA
Authorized Official - Prefix:
Authorized Official - First Name:ERIN
Authorized Official - Middle Name:
Authorized Official - Last Name:FARRELL
Authorized Official - Suffix:
Authorized Official - Credentials:MED, LBS
Authorized Official - Phone:267-709-9589
Mailing Address - Street 1:1 SUGARMAPLE LN
Mailing Address - Street 2:
Mailing Address - City:LEVITTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19055-2007
Mailing Address - Country:US
Mailing Address - Phone:267-709-9589
Mailing Address - Fax:267-583-3340
Practice Address - Street 1:1 SUGARMAPLE LN
Practice Address - Street 2:
Practice Address - City:LEVITTOWN
Practice Address - State:PA
Practice Address - Zip Code:19055-2007
Practice Address - Country:US
Practice Address - Phone:267-709-9589
Practice Address - Fax:267-583-3340
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-08
Last Update Date:2022-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251S00000X
PABH003020251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA103069299Medicaid
PA103069299-0016Medicaid