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General NPI Number Information
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NPI Number | 1851440622
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Entity Type | Organization
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Legal Business Name | LITTLE LAMBS DEVELOPMENTAL THERAPY, INC.
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Dates
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Enumeration Date | 01/09/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 3009 SUMMERWOOD DR
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City | SPRINGFIELD
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State | IL
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Zip | 62712-5862
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Country | US
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Telephone | 217-622-7725
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Fax | 217-529-1618
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Provider Business Mailing Address
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Address Line | 3009 SUMMERWOOD DR
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City | SPRINGFIELD
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State | IL
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Zip | 62712-5862
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Country | US
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Telephone | 217-622-7725
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Fax | 217-529-1618
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Authorized Official
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Title or Position | PRESIDENT
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Name | MRS. ANGELA MARIE PITTS
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Credential | M.A., D.T.
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Telephone | 217-622-7725
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251K00000X
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Taxonomy Name | Public Health or Welfare Agency
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License Number |
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License Number State |
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