Provider Demographics
NPI: | 1700429206 |
---|---|
Name: | KUTAMANI DEVELOPMENTAL SERVICES LLC |
Entity Type: | Organization |
Organization Name: | KUTAMANI DEVELOPMENTAL SERVICES LLC |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | VP OF BUSINESS AND DEVELOPMENT |
Authorized Official - Prefix: | MR |
Authorized Official - First Name: | DAVID |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | SUSSMAN |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 201-744-8871 |
Mailing Address - Street 1: | 707 GRANT ST FL 15 |
Mailing Address - Street 2: | |
Mailing Address - City: | PITTSBURGH |
Mailing Address - State: | PA |
Mailing Address - Zip Code: | 15219-1908 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 201-744-8871 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 707 GRANT ST FL 15 |
Practice Address - Street 2: | |
Practice Address - City: | PITTSBURGH |
Practice Address - State: | PA |
Practice Address - Zip Code: | 15219-1908 |
Practice Address - Country: | US |
Practice Address - Phone: | 201-744-8871 |
Practice Address - Fax: | |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2019-10-28 |
Last Update Date: | 2019-10-28 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 252Y00000X | Agencies | Early Intervention Provider Agency | ||
No | 101YM0800X | Behavioral Health & Social Service Providers | Counselor | Mental Health | Group - Multi-Specialty |
No | 103K00000X | Behavioral Health & Social Service Providers | Behavior Analyst | Group - Multi-Specialty | |
No | 103T00000X | Behavioral Health & Social Service Providers | Psychologist | Group - Multi-Specialty | |
No | 103TB0200X | Behavioral Health & Social Service Providers | Psychologist | Cognitive & Behavioral | Group - Multi-Specialty |
No | 104100000X | Behavioral Health & Social Service Providers | Social Worker | Group - Multi-Specialty | |
No | 133V00000X | Dietary & Nutritional Service Providers | Dietitian, Registered | Group - Multi-Specialty | |
No | 133VN1004X | Dietary & Nutritional Service Providers | Dietitian, Registered | Nutrition, Pediatric | Group - Multi-Specialty |
No | 171R00000X | Other Service Providers | Interpreter | Group - Multi-Specialty | |
No | 225100000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | Group - Multi-Specialty | |
No | 225X00000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist | Group - Multi-Specialty | |
No | 235Z00000X | Speech, Language and Hearing Service Providers | Speech-Language Pathologist | Group - Multi-Specialty | |
No | 251300000X | Agencies | Local Education Agency (LEA) | Group - Multi-Specialty | |
No | 251B00000X | Agencies | Case Management | ||
No | 251S00000X | Agencies | Community/Behavioral Health | Group - Multi-Specialty |