Provider Demographics
NPI:1952520397
Name:KIDS THERAPY WORKS, LLC
Entity Type:Organization
Organization Name:KIDS THERAPY WORKS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:MS
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:JORDAN
Authorized Official - Suffix:
Authorized Official - Credentials:SLP
Authorized Official - Phone:954-599-4185
Mailing Address - Street 1:600 N PINE ISLAND RD
Mailing Address - Street 2:SUITE 450
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33324-1393
Mailing Address - Country:US
Mailing Address - Phone:954-315-0139
Mailing Address - Fax:
Practice Address - Street 1:600 N PINE ISLAND RD
Practice Address - Street 2:SUITE 450
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33324-1393
Practice Address - Country:US
Practice Address - Phone:954-315-0139
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-24
Last Update Date:2007-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA6628235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty