Provider Demographics
NPI:1295901866
Name:KIDS THERAPY SERVICES, INC
Entity type:Organization
Organization Name:KIDS THERAPY SERVICES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OCCUPATIONAL THERAPIST/PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:LORI
Authorized Official - Middle Name:
Authorized Official - Last Name:GAVORSKI
Authorized Official - Suffix:
Authorized Official - Credentials:OTR
Authorized Official - Phone:317-518-6760
Mailing Address - Street 1:3100 MERIDIAN PARKE DR
Mailing Address - Street 2:SUITE N119
Mailing Address - City:GREENWOOD
Mailing Address - State:IN
Mailing Address - Zip Code:46142-9427
Mailing Address - Country:US
Mailing Address - Phone:317-518-6760
Mailing Address - Fax:317-422-4426
Practice Address - Street 1:3100 MERIDIAN PARKE DR
Practice Address - Street 2:SUITE N119
Practice Address - City:GREENWOOD
Practice Address - State:IN
Practice Address - Zip Code:46142-9427
Practice Address - Country:US
Practice Address - Phone:317-518-6760
Practice Address - Fax:317-422-4426
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-05
Last Update Date:2008-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN31002296A252Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency