Provider Demographics
NPI:1700345576
Name:KIDZ R MIRACLES CHILDCARE & THERAPY INC.
Entity Type:Organization
Organization Name:KIDZ R MIRACLES CHILDCARE & THERAPY INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KANDYCE
Authorized Official - Middle Name:KINTE
Authorized Official - Last Name:BYNUM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:312-363-9120
Mailing Address - Street 1:1044 W 112TH ST
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60643-4639
Mailing Address - Country:US
Mailing Address - Phone:312-363-9120
Mailing Address - Fax:312-453-6059
Practice Address - Street 1:1044 W 112TH ST
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60643-4639
Practice Address - Country:US
Practice Address - Phone:312-363-9120
Practice Address - Fax:312-453-6059
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-19
Last Update Date:2019-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency