Organization
SPARK KIDS COLLECTIVE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NICOLE WEINSTEIN (CEO)
(631) 678-8475
Entity
Organization
Contact information
Practice address
7653 CLINTON ST, LOS ANGELES, CA 90036-1822
(631) 678-8475
Mailing address
7653 CLINTON ST, LOS ANGELES, CA 90036-1822
(631) 678-8475
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
—
—
251E00000X
Home Health Agency
—
—
Other
Enumeration date
02/07/2024
Last updated
02/07/2024
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