Provider Demographics
NPI:1861873010
Name:IT TAKES A VILLAGE THERAPY SERVICES, LLC
Entity type:Organization
Organization Name:IT TAKES A VILLAGE THERAPY SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:
Authorized Official - Last Name:LANE
Authorized Official - Suffix:
Authorized Official - Credentials:OTR
Authorized Official - Phone:941-216-3885
Mailing Address - Street 1:6400 MANATEE AVE W
Mailing Address - Street 2:SUITE I
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34209-2378
Mailing Address - Country:US
Mailing Address - Phone:941-216-3885
Mailing Address - Fax:
Practice Address - Street 1:6400 MANATEE AVE W
Practice Address - Street 2:SUITE I
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34209-2378
Practice Address - Country:US
Practice Address - Phone:941-216-3885
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-13
Last Update Date:2015-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services