Healthcare Provider Details

I. General information

NPI: 1427200609
Provider Name (Legal Business Name): CHILDREN UNLIMITED, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/21/2008
Last Update Date: 03/22/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

182 W MAIN ST
CONWAY NH
03818-6140
US

IV. Provider business mailing address

182 W MAIN ST PO BOX 986
CONWAY NH
03818-6140
US

V. Phone/Fax

Practice location:
  • Phone: 603-447-6356
  • Fax: 603-447-1114
Mailing address:
  • Phone: 603-447-6356
  • Fax: 603-447-1114

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number1115
License Number StateNH
# 4
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number0327
License Number StateNH

VIII. Authorized Official

Name: MRS. SANDRA L PEARSON-KING
Title or Position: AUTHORIZED REPRESENTATIVE
Credential: SLP/CCC
Phone: 603-901-3050