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General NPI Number Information
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NPI Number | 1033905500
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Entity Type | Organization
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Legal Business Name | LIV LOVE PLAY CAFE LLC
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Dates
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Enumeration Date | 04/19/2025
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Last Update Date | 04/23/2025
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Provider Practice Location Address
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Address Line | 4520 W 140TH ST
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City | LEAWOOD
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State | KS
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Zip | 66224-3591
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Country | US
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Telephone | 913-744-6227
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Fax |
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Provider Business Mailing Address
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Address Line | 4520 W 140TH ST
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City | LEAWOOD
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State | KS
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Zip | 66224-3591
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Country | US
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Telephone | 913-744-6227
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Fax |
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Authorized Official
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Title or Position | OCCUPATIONAL THERAPIST
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Name | OLIVIA FRY
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Credential | OTR/L, MOT
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Telephone | 913-744-6227
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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