# COUNTRY KIDS INC.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1497851265
- **Authorized official:** MS. LISA KAFKA OTR (EXECUTIVE DIRECTOR)
- **Authorized official phone:** (920) 339-0700

## Contact information

- **Practice address:** 1142 ORLANDO DR, DE PERE, WI 54115-9484
- **Practice address phone:** (920) 339-0700
- **Practice address fax:** (920) 330-0278
- **Mailing address:** 1142 ORLANDO DR, DE PERE, WI 54115-9484
- **Mailing address phone:** (920) 339-0700
- **Mailing address fax:** (920) 330-0278

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 224Z00000X | Occupational Therapy Assistant | — | NULL | — |
| 224Z00000X | Occupational Therapy Assistant | — | — | — |
| 225100000X | Physical Therapist | — | NULL | — |
| 225100000X | Physical Therapist | — | — | — |
| 2251P0200X | Pediatric Physical Therapist | — | NULL | — |
| 2251P0200X | Pediatric Physical Therapist | — | — | — |
| 225200000X | Physical Therapy Assistant | — | NULL | — |
| 225200000X | Physical Therapy Assistant | — | — | — |
| 225X00000X | Occupational Therapist | — | NULL | — |
| 225X00000X | Occupational Therapist | — | — | — |
| 225XP0200X | Pediatric Occupational Therapist | — | NULL | — |
| 225XP0200X | Pediatric Occupational Therapist | — | — | — |
| 235Z00000X | Speech-Language Pathologist | — | NULL | — |
| 235Z00000X | Speech-Language Pathologist | — | — | — |
| 261QD1600X | Developmental Disabilities Clinic/Center | — | NULL | Yes |
| 261QH0700X | Hearing and Speech Clinic/Center | — | NULL | — |
| 261QP2000X | Physical Therapy Clinic/Center | — | NULL | — |
| 261QX0100X | Occupational Medicine Clinic/Center | — | NULL | — |

## Other

- **Enumeration date:** 09/16/2006
- **Last updated:** 08/28/2008