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General NPI Number Information
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NPI Number | 1740137447
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Entity Type | Organization
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Legal Business Name | KALEIDOSCOPE THERAPY SOLUTIONS CORP
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Dates
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Enumeration Date | 03/12/2026
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Last Update Date | 03/12/2026
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Provider Practice Location Address
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Address Line | 910 N MAIN ST
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City | BUSHNELL
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State | FL
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Zip | 33513-5006
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Country | US
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Telephone | 352-232-5222
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Fax |
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Provider Business Mailing Address
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Address Line | 27321 AZEN LOOP
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City | BROOKSVILLE
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State | FL
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Zip | 34602-7354
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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 | OWNER
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Name | JENNIFER HAINES
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Credential |
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Telephone | 352-232-5222
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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Taxonomy #2
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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 |
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Taxonomy #3
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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 #4
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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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