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NPI Code Detail

MEDICARE: KALEIDOSCOPE PEDIATRIC THERAPY LLC

MEDICARE: KALEIDOSCOPE PEDIATRIC THERAPY LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical TherapistPT-1860ID
2235Z00000XSpeech-Language PathologistSLP-1992ID
3225X00000XOccupational TherapistOT-709ID

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1154693364
Entity Type Code : Organization
Provider Name (Legal Business Name) : KALEIDOSCOPE PEDIATRIC THERAPY LLC
Provider Business Mailing Address
First Line : 7211 W FRANKLIN RD
Second Line :
City : BOISE
State : ID
Zip : 83709-0926
Country : US
Telephone Number : 208-375-4200
Fax Number : 208-375-4201
Provider Business Practice Location Address
First Line : 7211 W FRANKLIN RD
Second Line :
City : BOISE
State : ID
Zip : 83709-0926
Country : US
Telephone Number : 208-375-4200
Fax Number : 208-375-4201
Authorized Official
Title or Position : OWNER
Name : DR. KATIE ROWE
Credential : PT, DPT
Telephone Number : 208-375-4200
Provider Enumeration Date : 02/02/2012
Last Update Date : 02/01/2023

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Directions to “KALEIDOSCOPE PEDIATRIC THERAPY LLC ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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