Organization
KIDS INDIVIDUAL DEVELOPMENT SERVICES AZ LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KATHY LEHMEYER (CEO)
(458) 802-5080
Entity
Organization
Contact information
Practice address
528 COTTAGE ST NE STE 400, SALEM, OR 97301-3861
(623) 321-2811
(541) 275-0228
Mailing address
922 NW CIRCLE BLVD STE 160-112, CORVALLIS, OR 97330-1483
(541) 253-2115
(541) 275-0228
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
SKAZ0
—
AZ
Enumeration date
03/06/2024
Last updated
03/06/2024
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