Provider Demographics
NPI:1194236513
Name:KINDER IN THE KEYS
Entity type:Organization
Organization Name:KINDER IN THE KEYS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:
Authorized Official - Last Name:TANZINI
Authorized Official - Suffix:
Authorized Official - Credentials:DRPH
Authorized Official - Phone:909-230-5096
Mailing Address - Street 1:2435 PINE ST
Mailing Address - Street 2:
Mailing Address - City:POMONA
Mailing Address - State:CA
Mailing Address - Zip Code:91767-2179
Mailing Address - Country:US
Mailing Address - Phone:909-240-5096
Mailing Address - Fax:
Practice Address - Street 1:6 OCEAN VIEW BLVD
Practice Address - Street 2:
Practice Address - City:KEY LARGO
Practice Address - State:FL
Practice Address - Zip Code:33037-3833
Practice Address - Country:US
Practice Address - Phone:909-240-5096
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-12
Last Update Date:2017-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes323P00000XResidential Treatment FacilitiesPsychiatric Residential Treatment Facility