1235285891 NPI number — PLAYFUL INTERVENTIONS, INC.

Table of content: (NPI 1235285891)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1235285891 NPI number — PLAYFUL INTERVENTIONS, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
PLAYFUL INTERVENTIONS, INC.
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:
Provider Other Organization Name Type Code:
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:
1235285891
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
P.O. BOX 227
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LITHIA
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33547-0227
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
813-413-7785
Provider Business Mailing Address Fax Number:
407-386-7132

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5920 BEACONPARK ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LITHIA
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33547-5886
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
813-413-7785
Provider Business Practice Location Address Fax Number:
407-386-7132
Provider Enumeration Date:
01/26/2007

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
TAYLOR
Authorized Official First Name:
AMY
Authorized Official Middle Name:
J
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
813-413-7785

Provider Taxonomy Codes

  • Taxonomy code: 2251P0200X , with the licence number:  PT19005 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .
  • Taxonomy code: 225XP0200X , with the licence number: OT9965 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .
  • Taxonomy code: 225XP0200X , with the licence number: OT11388 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .
  • Taxonomy code: 235Z00000X , with the licence number: SA7645 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .
  • Taxonomy code: 235Z00000X , with the licence number: SA4830 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .

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