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COUNTRY KIDS INC. NPI 1497851265


NPI Information

NPI: 1497851265
Provider Name: COUNTRY KIDS INC.
Classification: Clinic/Center - 261QD1600X
Entity Type: Organization

Specialization: Developmental Disabilities

Address:
1142 ORLANDO DR
DE PERE, WI
ZIP 54115
Phone: (920) 339-0700
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COUNTRY KIDS INC. is a developmental disabilities clinic center in De Pere, WI. The provider is 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.). COUNTRY KIDS INC. NPI is 1497851265. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

1142 ORLANDO DR
DE PERE, WI
ZIP 54115-484
Phone: (920) 339-0700
Fax: (920) 330-0278

The provider's authorized official is Lisa Kafka .
The authorized official title is Executive Director and has the following contact phone number (920) 339-0700.

The enumeration date for this NPI number is 9/16/2006 and was last updated on 8/28/2008.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1235Z00000XSpeech-Language PathologistNo
2224Z00000XOccupational Therapy AssistantNo
3225100000XPhysical TherapistNo
42251P0200XPhysical TherapistPediatricsNo
5225200000XPhysical Therapy AssistantNo
6225X00000XOccupational TherapistNo
7225XP0200XOccupational TherapistPediatricsNo
8261QH0700XClinic/CenterHearing and SpeechNo
9261QP2000XClinic/CenterPhysical TherapyNo
10261QX0100XClinic/CenterOccupational MedicineNo
11261QD1600XClinic/CenterDevelopmental DisabilitiesYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
141217200MEDICAIDWISCONSIN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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