Organization
KIDWORKS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CYNTHIA S MANGAN (CEO)
(219) 983-9675
Entity
Organization
Contact information
Practice address
1120 S CALUMET RD STE 3, CHESTERTON, IN 46304-3286
(219) 916-4960
(219) 764-2751
Mailing address
1120 S CALUMET RD STE 3, CHESTERTON, IN 46304-3286
(219) 983-9675
(219) 983-9681
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
32001204A
IN
225100000X
Physical Therapist
05008714A
IN
225200000X
Physical Therapy Assistant
06003228A
IN
225X00000X
Occupational Therapist
Primary
31003944A
IN
235Z00000X
Speech-Language Pathologist
22003689A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200815860
—
IN
Enumeration date
10/27/2006
Last updated
04/30/2008
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