Provider Demographics
NPI:1396344347
Name:CHILD'S PLAY THERAPY LLC
Entity type:Organization
Organization Name:CHILD'S PLAY THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:TAYLOR
Authorized Official - Middle Name:
Authorized Official - Last Name:DAVIDSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-974-9919
Mailing Address - Street 1:3057 LORNA RD STE 220
Mailing Address - Street 2:
Mailing Address - City:HOOVER
Mailing Address - State:AL
Mailing Address - Zip Code:35216-4518
Mailing Address - Country:US
Mailing Address - Phone:404-974-9919
Mailing Address - Fax:
Practice Address - Street 1:3057 LORNA RD STE 220
Practice Address - Street 2:
Practice Address - City:HOOVER
Practice Address - State:AL
Practice Address - Zip Code:35216-4518
Practice Address - Country:US
Practice Address - Phone:404-974-9919
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-21
Last Update Date:2020-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes273Y00000XHospital UnitsRehabilitation Unit
No251300000XAgenciesLocal Education Agency (LEA)