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Organization

KIDS SOURCE, INC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. PATRICIA MARTIN-BROWN M.S., NCSP (PRESIDENT)
(317) 873-6952
Entity
Organization

Contact information

Practice address
260 BEECHWOOD LN, ZIONSVILLE, IN 46077-1213
(317) 873-6952
(317) 873-6952
Mailing address
260 BEECHWOOD LN, ZIONSVILLE, IN 46077-1213
(317) 873-6952
(317) 873-6952

Taxonomy

Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
200724480A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
200724480A
FIRST STEPS PROVIDER NO
IN
Enumeration date
10/25/2006
Last updated
04/15/2008
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