Provider Demographics
NPI:1457016404
Name:CHICKADEE THERAPY SERVICES, LLC
Entity Type:Organization
Organization Name:CHICKADEE THERAPY SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:
Authorized Official - Last Name:FALSO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:207-579-4255
Mailing Address - Street 1:17 CAMPGROUND LN
Mailing Address - Street 2:
Mailing Address - City:OXFORD
Mailing Address - State:ME
Mailing Address - Zip Code:04270-3151
Mailing Address - Country:US
Mailing Address - Phone:207-688-8486
Mailing Address - Fax:
Practice Address - Street 1:17 CAMPGROUND LN
Practice Address - Street 2:
Practice Address - City:OXFORD
Practice Address - State:ME
Practice Address - Zip Code:04270-3151
Practice Address - Country:US
Practice Address - Phone:207-579-4255
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-04
Last Update Date:2022-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty