Basic Information
| Provider Information | |||||||||
| NPI: | 1942729603 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | CAROLINA THERAPY SOLUTIONS FOR KIDS, LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 458 ANVIL DRAW PL | ||||||||
| Address2: | |||||||||
| City: | ROCK HILL | ||||||||
| State: | SC | ||||||||
| PostalCode: | 297309236 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8035773701 | ||||||||
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| Practice Location | |||||||||
| Address1: | 236 NORTHPARK DR STE 101 | ||||||||
| Address2: | |||||||||
| City: | ROCK HILL | ||||||||
| State: | SC | ||||||||
| PostalCode: | 297304294 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8033242202 | ||||||||
| FaxNumber: | 8036203087 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/13/2017 | ||||||||
| LastUpdateDate: | 09/29/2021 | ||||||||
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| AuthorizedOfficialLastName: | MOOD | ||||||||
| AuthorizedOfficialFirstName: | KIMBERLY | ||||||||
| AuthorizedOfficialMiddleName: | HAGWOOD | ||||||||
| AuthorizedOfficialTitleorPosition: | FOUNDER AND CEO | ||||||||
| AuthorizedOfficialTelephone: | 8035773701 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MRS. | ||||||||
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| AuthorizedOfficialCredential: | M.S., OTR/L | ||||||||
| NPICertificationDate: | 09/29/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 224Z00000X | N | 193200000X MULTI-SPECIALTY GROUP | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapy Assistant | 225100000X | N | 193200000X MULTI-SPECIALTY GROUP | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | 225200000X | N | 193200000X MULTI-SPECIALTY GROUP | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapy Assistant | 235Z00000X | N | 193200000X MULTI-SPECIALTY GROUP | Speech, Language and Hearing Service Providers | Speech-Language Pathologist | 225X00000X | Y | 193200000X MULTI-SPECIALTY GROUP | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist |
No ID Information.