Provider Demographics
NPI:1265591275
Name:CHILDREN FAMILY INTERVENTION RESPIT SERVICES AND THERAPY
Entity type:Organization
Organization Name:CHILDREN FAMILY INTERVENTION RESPIT SERVICES AND THERAPY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF FINANCE
Authorized Official - Prefix:
Authorized Official - First Name:DIANE
Authorized Official - Middle Name:
Authorized Official - Last Name:SAGGAU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:509-315-5711
Mailing Address - Street 1:2510 N PINES RD STE 1
Mailing Address - Street 2:
Mailing Address - City:SPOKANE VALLEY
Mailing Address - State:WA
Mailing Address - Zip Code:99206-7636
Mailing Address - Country:US
Mailing Address - Phone:509-315-5711
Mailing Address - Fax:509-443-4170
Practice Address - Street 1:2510 N PINES RD STE 1
Practice Address - Street 2:
Practice Address - City:SPOKANE VALLEY
Practice Address - State:WA
Practice Address - Zip Code:99206-7636
Practice Address - Country:US
Practice Address - Phone:509-315-5711
Practice Address - Fax:509-443-4170
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-06
Last Update Date:2021-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatricsGroup - Multi-Specialty
No225100000XRespiratory, 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
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA7098619Medicaid
WA7683725Medicaid