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NPI Code Detail

MEDICARE: KIDSTLC, INC

MEDICARE: KIDSTLC, 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
12251P0200XPediatric Physical Therapist
2225XM0800XMental Health Occupational Therapist
3235Z00000XSpeech-Language Pathologist

General Provider Information

NPI Number : 1780014480
Entity Type Code : Organization
Provider Name (Legal Business Name) : KIDSTLC, INC
Provider Business Mailing Address
First Line : 480 S ROGERS RD
Second Line :
City : OLATHE
State : KS
Zip : 66062-1706
Country : US
Telephone Number : 913-324-3636
Fax Number : 913-780-3387
Provider Business Practice Location Address
First Line : 620 S ROGERS RD
Second Line :
City : OLATHE
State : KS
Zip : 66062-1704
Country : US
Telephone Number : 913-324-3823
Fax Number : 913-780-3387
Authorized Official
Title or Position : CFO
Name : MARY THOMAS
Credential :
Telephone Number : 913-324-3681
Provider Enumeration Date : 11/15/2013
Last Update Date : 07/15/2021

Similar Medicare Providers

1952251530 — ABIGAIL MARIE ENGLERT
Practice Location Address:
620 S ROGERS RD
OLATHE, KS
66062-1704
Practice Phone: 913-324-3387
Practice Fax: 913-780-3387
1245404821 — TRACY LYNNE SCHMITT LBA
Practice Location Address:
620 S ROGERS RD
OLATHE, KS
66062-1704
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1275829814 — LAUREN W BINGHAM BCABA
Practice Location Address:
620 S ROGERS RD
OLATHE, KS
66062-1704
Practice Phone: 913-324-3849
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1245673185 — BETTY JOAN JOHNSON
Practice Location Address:
620 S ROGERS RD
OLATHE, KS
66062-1704
Practice Phone: 913-324-3618
Practice Fax:
1295177814 — KIDSTLC, INC.
Practice Location Address:
620 S ROGERS RD
OLATHE, KS
66062-1704
Practice Phone: 913-764-2887
Practice Fax: 913-780-3387
1437583168 — MRS. DANIELLE M JOHNSON PHD
Practice Location Address:
620 S ROGERS RD
OLATHE, KS
66062-1704
Practice Phone: 913-324-3823
Practice Fax: 913-768-1437

Directions to “KIDSTLC, INC ” Practice Location

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