Super Cool Kids Therapy, LLC

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

SUPER COOL KIDS THERAPY, LLC

Practice address

14175 W Indian School Rd
Suite B4-521
Goodyear, AZ 85395-8407

Phone

(623) 262-1199

NPI assigned

Sep 14, 2008

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Lou Krejci

Title

Owner

Phone

(623) 262-1199

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1221350400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1221350400000",
    "number": "1053560110",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14175 W INDIAN SCHOOL RD",
            "address_2": "SUITE B4-521",
            "city": "GOODYEAR",
            "state": "AZ",
            "postal_code": "853958407"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14175 W INDIAN SCHOOL RD",
            "address_2": "SUITE B4-521",
            "city": "GOODYEAR",
            "state": "AZ",
            "postal_code": "853958407",
            "telephone_number": "623-262-1199"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUPER COOL KIDS THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-09-14",
        "last_updated": "2008-09-14",
        "status": "A",
        "authorized_official_last_name": "KREJCI",
        "authorized_official_first_name": "LOU",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "623-262-1199"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinic/Center in Goodyear, AZ
• Providers in Goodyear, AZ by specialty
• Clinic/Center in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.