Provider Demographics
NPI:1144044736
Name:MOTOR SKILLS INDOOR PLAYGROUND LLC
Entity type:Organization
Organization Name:MOTOR SKILLS INDOOR PLAYGROUND LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/COTA
Authorized Official - Prefix:
Authorized Official - First Name:MEG
Authorized Official - Middle Name:
Authorized Official - Last Name:SHERWOOD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:760-484-2298
Mailing Address - Street 1:1669 CHEROKEE RD APT B
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:SC
Mailing Address - Zip Code:29501-4180
Mailing Address - Country:US
Mailing Address - Phone:760-484-2298
Mailing Address - Fax:
Practice Address - Street 1:1669 CHEROKEE RD APT B
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:SC
Practice Address - Zip Code:29501-4180
Practice Address - Country:US
Practice Address - Phone:760-484-2298
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-11
Last Update Date:2024-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes224ZF0002XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy AssistantFeeding, Eating & SwallowingGroup - Single Specialty