Healthcare Provider Details

I. General information

NPI: 1154081719
Provider Name (Legal Business Name): KIDS THERAPY SOLUTIONS CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/23/2021
Last Update Date: 12/16/2023
Certification Date: 12/16/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 S MAIN ST
LABELLE FL
33935-4440
US

IV. Provider business mailing address

700 S MAIN ST
LABELLE FL
33935-4440
US

V. Phone/Fax

Practice location:
  • Phone: 786-567-0868
  • Fax:
Mailing address:
  • Phone: 786-567-0868
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM3000X
TaxonomyMedically Fragile Infants and Children Day Care
License Number
License Number State

VIII. Authorized Official

Name: JENIREE CAROLINA CONSTANTINO RIOS
Title or Position: OWNER
Credential:
Phone: 786-567-0868