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General NPI Number Information
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NPI Number | 1306715206
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Entity Type | Organization
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Legal Business Name | WINDFALL KIDS & CO.,LLC
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Dates
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Enumeration Date | 10/30/2025
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Last Update Date | 10/30/2025
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Provider Practice Location Address
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Address Line | 4005 SAWMILL TRACE DR
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City | CHARLOTTE
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State | NC
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Zip | 28213-4860
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Country | US
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Telephone | 980-319-8471
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Fax |
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Provider Business Mailing Address
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Address Line | 4005 SAWMILL TRACE DR
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City | CHARLOTTE
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State | NC
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Zip | 28213-4860
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | FLORIAN PORTIS
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Credential |
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Telephone | 202-699-2039
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 2251P0200X
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Taxonomy Name | Pediatric Physical Therapist
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 225XP0200X
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Taxonomy Name | Pediatric Occupational Therapist
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 2355S0801X
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Taxonomy Name | Speech-Language Assistant
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number |
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License Number State |
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