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General NPI Number Information
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NPI Number | 1679614754
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Entity Type | Organization
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Legal Business Name | CHILDSERVE THERAPY, INC.
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Dates
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Enumeration Date | 02/09/2007
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Last Update Date | 09/10/2020
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Provider Practice Location Address
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Address Line | 5406 MERLE HAY RD
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City | JOHNSTON
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State | IA
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Zip | 50131-1209
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Country | US
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Telephone | 515-727-8750
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Fax | 515-727-8757
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Provider Business Mailing Address
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Address Line | PO BOX 707
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City | JOHNSTON
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State | IA
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Zip | 50131-0707
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Country | US
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Telephone | 515-727-8750
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Fax | 515-727-8757
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Authorized Official
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Title or Position | DIRECTOR OF FINANCE
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Name | JENNIFER PAVLOVEC
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Credential |
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Telephone | 515-727-1463
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 224Z00000X
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Taxonomy Name | Occupational Therapy Assistant
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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 | 2251P0200X
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Taxonomy Name | Pediatric Physical Therapist
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License Number |
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License Number State | IA
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Taxonomy #3
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Taxonomy Code | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number |
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License Number State | IA
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Taxonomy #4
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number |
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License Number State | IA
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Taxonomy #5
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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 | IA
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Taxonomy #6
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Taxonomy Code | 231H00000X
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Taxonomy Name | Audiologist
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License Number |
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License Number State | IA
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Taxonomy #7
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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 #8
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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