MEDICARE: LET'S GO PLAY, INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251V00000X	Voluntary or Charitable Agency	3761387	PA

General Provider Information

NPI Number	:	1316268675
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LET'S GO PLAY, INC

Provider Business Mailing Address
First Line	:	225 S CHESTER RD
Second Line	:	SUITE 4
City	:	SWARTHMORE
State	:	PA
Zip	:	19081-1919
Country	:	US
Telephone Number	:	484-472-8712
Fax Number	:

Provider Business Practice Location Address
First Line	:	225 S CHESTER RD
Second Line	:	SUITE 4
City	:	SWARTHMORE
State	:	PA
Zip	:	19081-1919
Country	:	US
Telephone Number	:	484-472-8712
Fax Number	:

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	MS. GINGER S. ROWAN
Credential	:	M.S.
Telephone Number	:	484-472-8712

Provider Enumeration Date	:	06/21/2010
Last Update Date	:	06/21/2010

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