Provider Demographics
NPI:1912301755
Name:WHEN KIDS PLAY LLC
Entity Type:Organization
Organization Name:WHEN KIDS PLAY LLC
Other - Org Name:WHEN KIDS PLAY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OCCUPATIONAL THERAPIST, COOWNER
Authorized Official - Prefix:
Authorized Official - First Name:LEILANI
Authorized Official - Middle Name:
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:OTR
Authorized Official - Phone:817-475-3358
Mailing Address - Street 1:1169 N BURLESON BLVD
Mailing Address - Street 2:SUITE 107-225
Mailing Address - City:BURLESON
Mailing Address - State:TX
Mailing Address - Zip Code:76028-7011
Mailing Address - Country:US
Mailing Address - Phone:817-475-3358
Mailing Address - Fax:
Practice Address - Street 1:2706 PINNACLE DR
Practice Address - Street 2:
Practice Address - City:BURLESON
Practice Address - State:TX
Practice Address - Zip Code:76028-8315
Practice Address - Country:US
Practice Address - Phone:817-475-3358
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-21
Last Update Date:2016-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251S00000XAgenciesCommunity/Behavioral Health
No252Y00000XAgenciesEarly Intervention Provider Agency
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX358477302Medicaid
TX358477301Medicaid