Provider Demographics
NPI:1104671924
Name:CAROLINA KIDS EARLY INTERVENTION LLC
Entity type:Organization
Organization Name:CAROLINA KIDS EARLY INTERVENTION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTINE
Authorized Official - Middle Name:
Authorized Official - Last Name:SPEEGLE
Authorized Official - Suffix:
Authorized Official - Credentials:EI
Authorized Official - Phone:803-479-1463
Mailing Address - Street 1:58 DRAYTON CT
Mailing Address - Street 2:
Mailing Address - City:PROSPERITY
Mailing Address - State:SC
Mailing Address - Zip Code:29127-9375
Mailing Address - Country:US
Mailing Address - Phone:803-479-1463
Mailing Address - Fax:
Practice Address - Street 1:58 DRAYTON CT
Practice Address - Street 2:
Practice Address - City:PROSPERITY
Practice Address - State:SC
Practice Address - Zip Code:29127-9375
Practice Address - Country:US
Practice Address - Phone:803-479-1463
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-23
Last Update Date:2024-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency