Provider Demographics
NPI:1104902337
Name:CHILDRENS THERAPY GROUP INC
Entity type:Organization
Organization Name:CHILDRENS THERAPY GROUP INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:K
Authorized Official - Last Name:BANKER
Authorized Official - Suffix:
Authorized Official - Credentials:OTRL
Authorized Official - Phone:913-383-9014
Mailing Address - Street 1:7620 METCALF AVENUE
Mailing Address - Street 2:SUITE M
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66204-2996
Mailing Address - Country:US
Mailing Address - Phone:913-383-9014
Mailing Address - Fax:913-383-9015
Practice Address - Street 1:7620 METCALF AVENUE
Practice Address - Street 2:SUITE M
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66204-2996
Practice Address - Country:US
Practice Address - Phone:913-383-9014
Practice Address - Fax:913-383-9015
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-31
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatricsGroup - Single Specialty
Not Answered225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatricsGroup - Single Specialty
Not Answered235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS584130OtherBLUE CROSS BLUE SHIELD
MO13401015OtherBLUE CROSS BLUE SHIELD