Provider Demographics
NPI:1932374063
Name:TEAM 4 KIDS
Entity type:Organization
Organization Name:TEAM 4 KIDS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/OPERATOR
Authorized Official - Prefix:
Authorized Official - First Name:KRYSTAL
Authorized Official - Middle Name:
Authorized Official - Last Name:GRABEEL-HAMLIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:859-753-8333
Mailing Address - Street 1:PO BOX 723
Mailing Address - Street 2:
Mailing Address - City:VERSAILLES
Mailing Address - State:KY
Mailing Address - Zip Code:40383-0723
Mailing Address - Country:US
Mailing Address - Phone:859-753-8333
Mailing Address - Fax:
Practice Address - Street 1:118 SHETLAND RD
Practice Address - Street 2:
Practice Address - City:VERSAILLES
Practice Address - State:KY
Practice Address - Zip Code:40383-1703
Practice Address - Country:US
Practice Address - Phone:859-753-8333
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-29
Last Update Date:2008-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management