Provider Demographics
NPI:1457418089
Name:CHILDS PLAY BY THE BAY
Entity Type:Organization
Organization Name:CHILDS PLAY BY THE BAY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:ALESIA
Authorized Official - Middle Name:
Authorized Official - Last Name:GRIFFITH
Authorized Official - Suffix:
Authorized Official - Credentials:OTR
Authorized Official - Phone:302-645-2153
Mailing Address - Street 1:1002 KINGS HWY
Mailing Address - Street 2:
Mailing Address - City:LEWES
Mailing Address - State:DE
Mailing Address - Zip Code:19958-1707
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:302-645-2943
Practice Address - Street 1:1002 KINGS HWY
Practice Address - Street 2:
Practice Address - City:LEWES
Practice Address - State:DE
Practice Address - Zip Code:19958-1707
Practice Address - Country:US
Practice Address - Phone:302-645-2153
Practice Address - Fax:302-645-2943
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DE225400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation PractitionerGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE1000034826Medicaid