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Organization
KIDDOS THERAPY KONNECTION LLC
Active
Organization
KIDDOS THERAPY KONNECTION LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHARLIE COCHRAN JR. (OWNER)
(337) 502-9533
Entity
Organization
Contact information
Practice address
814 W MCNEESE ST # 241, LAKE CHARLES, LA 70605-5426
(337) 502-9533
Mailing address
814 W MCNEESE ST # 241, LAKE CHARLES, LA 70605-5426
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
1041C0700X
Clinical Social Worker
—
—
251B00000X
Case Management Agency
—
—
251S00000X
Community/Behavioral Health Agency
—
—
320700000X
Physical Disabilities Residential Treatment Facility
Primary
—
—
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
Other
Enumeration date
09/01/2019
Last updated
09/01/2019
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