Organization · Type 2 NPI
Kidspace Therapy, LLC
Developmental Disabilities Clinic/Center · Longview, WA
Practice location
2145 Tibbetts Dr Ste A
Longview, WA 98632-4211
Fax (360) 703-3452
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Clinic/Center | 261Q00000X | OT00001294 (WA) |
| Developmental Disabilities Clinic/Center Primary | 261QD1600X | 603464065 (WA) |
Developmental Disabilities Clinic/Center: An entity, facility, or distinct part of a facility providing comprehensive, multidiscipline diagnostic, treatment, therapy, training, and counseling services to children with congenital disorders that precipitate developmental delays and in many instances mental deficiencies (e.g., Cerebral Palsy, metabolic disorders, Sturge-Weber Syndrome, etc.).
Another provider at this address
About NPI 1184019184
Kidspace Therapy, LLC's National Provider Identifier is 1184019184, issued on Apr 6, 2015. The primary taxonomy on file is Developmental Disabilities Clinic/Center (261QD1600X), and the practice location is in Longview, WA. The record was last updated on Jul 15, 2020.