Provider Demographics
NPI:1841886462
Name:KIDSPIRATION PEDIATRIC THERAPY SERVICES
Entity type:Organization
Organization Name:KIDSPIRATION PEDIATRIC THERAPY SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LEAH
Authorized Official - Middle Name:M
Authorized Official - Last Name:COLMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:870-424-4021
Mailing Address - Street 1:PO BOX 2355
Mailing Address - Street 2:
Mailing Address - City:MOUNTAIN HOME
Mailing Address - State:AR
Mailing Address - Zip Code:72654
Mailing Address - Country:US
Mailing Address - Phone:870-424-4021
Mailing Address - Fax:870-424-4112
Practice Address - Street 1:1310 BRADLEY DR
Practice Address - Street 2:
Practice Address - City:MOUNTAIN HOME
Practice Address - State:AR
Practice Address - Zip Code:72653
Practice Address - Country:US
Practice Address - Phone:870-424-4021
Practice Address - Fax:870-424-4112
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:KIDSPIRATION PEDIATRIC THERAPY SERVIC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-12-17
Last Update Date:2020-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty