1750727798 NPI number — THERAPLAY4KIDZ, LLC

Table of content: (NPI 1750727798)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1750727798 NPI number — THERAPLAY4KIDZ, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
THERAPLAY4KIDZ, LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
ARIZONA AUTISM
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1750727798
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/23/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
530 E MCDOWELL RD STE 107-495
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PHOENIX
Provider Business Mailing Address State Name:
AZ
Provider Business Mailing Address Postal Code:
85004-1549
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
602-726-2300
Provider Business Mailing Address Fax Number:
602-726-2322

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
7120 E SAHUARO DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SCOTTSDALE
Provider Business Practice Location Address State Name:
AZ
Provider Business Practice Location Address Postal Code:
85254-5238
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
602-726-8525
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/17/2013

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
SHERMAN
Authorized Official First Name:
RYAN
Authorized Official Middle Name:
R
Authorized Official Title or Position:
OCCUPATIONAL THERAPIST
Authorized Official Telephone Number:
602-319-7324

Provider Taxonomy Codes

  • Taxonomy code: 103K00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 225100000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 225400000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 225X00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 235Z00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 132997 , issued by the state of ( AZ ) . This identifiers is of the category "MEDICAID".
  • Identifier: 974463 , issued by the state of ( AZ ) . This identifiers is of the category "MEDICAID".