Provider Demographics
NPI:1831919182
Name:PLAYFUL PATHS
Entity type:Organization
Organization Name:PLAYFUL PATHS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:
Authorized Official - Last Name:AMARNATH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:321-243-9551
Mailing Address - Street 1:2775 BOSQUE CIR APT 208
Mailing Address - Street 2:
Mailing Address - City:MELBOURNE
Mailing Address - State:FL
Mailing Address - Zip Code:32940-3233
Mailing Address - Country:US
Mailing Address - Phone:321-243-9551
Mailing Address - Fax:
Practice Address - Street 1:2775 BOSQUE CIR APT 208
Practice Address - Street 2:
Practice Address - City:MELBOURNE
Practice Address - State:FL
Practice Address - Zip Code:32940-3233
Practice Address - Country:US
Practice Address - Phone:321-243-9551
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-11
Last Update Date:2024-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes252Y00000XAgenciesEarly Intervention Provider Agency
No222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental TherapistGroup - Single Specialty