Kid's Fort Developmental Center LLC

Primary specialty

Developmental Disabilities Clinic/CenterTaxonomy code 261QD1600X

Legal business name

KID'S FORT DEVELOPMENTAL CENTER LLC

Doing business as

Kid's Fort Developmental Center LLC

Practice address

3757 Scafati Ave
Henderson, NV 89044-1908

Phone

(907) 744-6981

NPI assigned

Apr 5, 2024

Last updated

Apr 5, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ralph Dimaano

Title

Managing Partner

Phone

(907) 744-6981

Specialties & licenses 1

Addresses

Other names 1

• Kid's Fort Developmental Center LLC Doing business as

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

{
    "created_epoch": "1712275200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1712275200000",
    "number": "1407609951",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3757 SCAFATI AVE",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890441908",
            "telephone_number": "907-744-6981"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3757 SCAFATI AVE",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890441908",
            "telephone_number": "907-744-6981"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KID'S FORT DEVELOPMENTAL CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-04-05",
        "last_updated": "2024-04-05",
        "certification_date": "2024-04-05",
        "status": "A",
        "authorized_official_last_name": "DIMAANO",
        "authorized_official_first_name": "RALPH",
        "authorized_official_title_or_position": "MANAGING PARTNER",
        "authorized_official_telephone_number": "907-744-6981"
    },
    "taxonomies": [
        {
            "code": "261QD1600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kid's Fort Developmental Center LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Susan Kilburn, RN-C, APN

• Developmental Disabilities Clinic/Center in Henderson, NV
• Providers in Henderson, NV by specialty
• Developmental Disabilities Clinic/Center in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2024; 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.