Kids House of Seminole

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

IMH15952 Issued in FL

Legal business name

KIDS HOUSE OF SEMINOLE

Practice address

5467 Ronald Reagan Blvd
Sanford, FL 32773-6332

Phone

(407) 324-3036

NPI assigned

May 11, 2017

Last updated

May 11, 2017By 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

Denise Conus

Title

Mental Health Program Director

Phone

(407) 324-3036

Specialties & licenses 1

Addresses

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Tax ID family

Kids House of Seminole2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Kids House of Seminole, Inc.

  • Specialist
  • Sanford, FL
  • NPI 1508998675
  NPD tax ID

Locations

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

{
    "created_epoch": "1494460800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1494460800000",
    "number": "1710414511",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5467 RONALD REAGAN BLVD",
            "city": "SANFORD",
            "state": "FL",
            "postal_code": "327736332"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5467 RONALD REAGAN BLVD",
            "city": "SANFORD",
            "state": "FL",
            "postal_code": "327736332",
            "telephone_number": "407-324-3036"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIDS HOUSE OF SEMINOLE",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-05-11",
        "last_updated": "2017-05-11",
        "status": "A",
        "authorized_official_last_name": "CONUS",
        "authorized_official_first_name": "DENISE",
        "authorized_official_title_or_position": "MENTAL HEALTH PROGRAM DIRECTOR",
        "authorized_official_telephone_number": "407-324-3036"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "FL",
            "license": "IMH15952",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Valerie Keen, PTA
• Lauren B. Keene, D.P.T.
• Tamara Kelly Brown, RPH
• Eileen Kelly, ARNP
• Katherine Elizabeth Kersjes
• Kids House of Seminole, Inc.
• Kim-S Acupuncture Clinic Inc. (Sage Wellness Center)
• Eileen E Kim, PA-C
• Jeffrey Kim, DPT
• Jin Ho Kim, DOM, AP, LAC, PD.D.

• Community/Behavioral Health Agency in Sanford, FL
• Providers in Sanford, FL by specialty
• Community/Behavioral Health Agency in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.