Organization
KIDS INTERACTIVE DEVELOPMENTAL SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. PAMELA RAGAN (OWNER)
(704) 224-3687
Entity
Organization
Contact information
Practice address
1154 BELMONT CT, CONCORD, NC 28027-8666
(704) 224-3687
(704) 785-8096
Mailing address
1154 BELMONT CT, CONCORD, NC 28027-8666
(704) 224-3687
(704) 785-8096
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8301595
—
NC
Enumeration date
07/05/2007
Last updated
05/21/2009
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