Provider Demographics
NPI:1124153424
Name:INFANT TODDLER SERVICES OF JOHNSON COUNTY
Entity type:Organization
Organization Name:INFANT TODDLER SERVICES OF JOHNSON COUNTY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:AMY
Authorized Official - Middle Name:
Authorized Official - Last Name:OWENS
Authorized Official - Suffix:
Authorized Official - Credentials:OTR
Authorized Official - Phone:913-432-2900
Mailing Address - Street 1:6400 GLENWOOD ST
Mailing Address - Street 2:SUITE 205
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66202-4016
Mailing Address - Country:US
Mailing Address - Phone:913-432-2900
Mailing Address - Fax:913-432-2901
Practice Address - Street 1:6400 GLENWOOD ST
Practice Address - Street 2:SUITE 205
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66202-4016
Practice Address - Country:US
Practice Address - Phone:913-432-2900
Practice Address - Fax:913-432-2901
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered133VN1004XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, PediatricGroup - Multi-Specialty
Not Answered2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatricsGroup - Multi-Specialty
Not Answered225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatricsGroup - Multi-Specialty
Not Answered235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO34084017OtherBCBS OF KANSAS CITY GROUP