Invictus 1776, LLC

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

Legal business name

INVICTUS 1776, LLC

Doing business as

Koala Academy Pediatric Therapies

Practice address

5555 San Felipe St FL 20
Houston, TX 77056-2701

Phone

(832) 954-8554

NPI assigned

Jul 15, 2021

Organization subpart

No

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

Authorized official

Name

Lauren Records

Title

Executive Director

Phone

(832) 954-8554

Specialties & licenses 3

Addresses

Other names 1

• Koala Academy Pediatric Therapies Doing business as

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

{
    "created_epoch": "1626307200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1626307200000",
    "number": "1386216612",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5555 SAN FELIPE ST FL 20",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770562701",
            "telephone_number": "832-954-8554"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5555 SAN FELIPE ST FL 20",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770562701",
            "telephone_number": "832-954-8554"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INVICTUS 1776, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-07-15",
        "last_updated": "2021-07-15",
        "certification_date": "2021-07-15",
        "status": "A",
        "authorized_official_last_name": "RECORDS",
        "authorized_official_first_name": "LAUREN",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "832-954-8554"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Koala Academy Pediatric Therapies",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Behavior Analyst in Houston, TX
• Providers in Houston, TX by specialty
• Behavior Analyst in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2021; 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.