Provider Demographics
NPI: | 1992107999 |
---|---|
Name: | THERAPIES 4 KIDS, INC. |
Entity type: | Organization |
Organization Name: | THERAPIES 4 KIDS, INC. |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | CREDENTIALING AND COMPLIANCE SPECIA |
Authorized Official - Prefix: | MRS |
Authorized Official - First Name: | LILY |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | YANES |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 954-431-9838 |
Mailing Address - Street 1: | 2010 NW 150TH AVE STE 120 |
Mailing Address - Street 2: | |
Mailing Address - City: | PEMBROKE PINES |
Mailing Address - State: | FL |
Mailing Address - Zip Code: | 33028-2888 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 954-431-9838 |
Mailing Address - Fax: | 954-241-6726 |
Practice Address - Street 1: | 2010 NW 150TH AVE STE 120 |
Practice Address - Street 2: | |
Practice Address - City: | PEMBROKE PINES |
Practice Address - State: | FL |
Practice Address - Zip Code: | 33028-2888 |
Practice Address - Country: | US |
Practice Address - Phone: | 954-431-9838 |
Practice Address - Fax: | 954-241-6726 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2014-09-22 |
Last Update Date: | 2023-01-12 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 261Q00000X | Ambulatory Health Care Facilities | Clinic/Center | Group - Multi-Specialty | |
No | 101YM0800X | Behavioral Health & Social Service Providers | Counselor | Mental Health | Group - Multi-Specialty |
No | 103K00000X | Behavioral Health & Social Service Providers | Behavior Analyst | Group - Multi-Specialty | |
No | 103T00000X | Behavioral Health & Social Service Providers | Psychologist | Group - Multi-Specialty | |
No | 104100000X | Behavioral Health & Social Service Providers | Social Worker | Group - Multi-Specialty | |
No | 106E00000X | Behavioral Health & Social Service Providers | Assistant Behavior Analyst | Group - Multi-Specialty | |
No | 106S00000X | Behavioral Health & Social Service Providers | Behavior Technician | Group - Multi-Specialty | |
No | 2084B0040X | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Behavioral Neurology & Neuropsychiatry | Group - Multi-Specialty |
No | 2084P0800X | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Psychiatry | Group - Multi-Specialty |
No | 2084P0804X | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Child & Adolescent Psychiatry | Group - Multi-Specialty |
No | 261QM1300X | Ambulatory Health Care Facilities | Clinic/Center | Multi-Specialty | Group - Multi-Specialty |
No | 363LA2100X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Acute Care | Group - Multi-Specialty |
No | 363LA2200X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Adult Health | Group - Multi-Specialty |
No | 363LP0808X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Psychiatric/Mental Health | Group - Multi-Specialty |
Provider Identifiers
State | Identifier ID | ID Type | Issuer |
---|---|---|---|
FL | O215781815050 | Other | DMV |