Provider Demographics
NPI:1134853849
Name:THE PLAYFUL PLACE FOR ALL, LLC.
Entity type:Organization
Organization Name:THE PLAYFUL PLACE FOR ALL, LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BCBA/ OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:
Authorized Official - Last Name:DESROSIERS
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA, LABA
Authorized Official - Phone:508-789-9323
Mailing Address - Street 1:424 AUTUMN AVE
Mailing Address - Street 2:
Mailing Address - City:DUXBURY
Mailing Address - State:MA
Mailing Address - Zip Code:02332-4621
Mailing Address - Country:US
Mailing Address - Phone:508-789-9323
Mailing Address - Fax:781-319-2882
Practice Address - Street 1:462 PLAIN ST
Practice Address - Street 2:
Practice Address - City:MARSHFIELD
Practice Address - State:MA
Practice Address - Zip Code:02050-2731
Practice Address - Country:US
Practice Address - Phone:508-789-9323
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-11
Last Update Date:2022-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty