| Organization Name: | CHILDSERVE THERAPY INC. |
| NPI Number: | 1073731378 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | RODNEY WILDRICK (DIRECTOR OF ACCOUNTING) |
| Mailing Address: | 5406 Merle Hay Rd Johnston |
| State: | IA US |
| Postal Code: | 501311209 |
| Phone Number: | 5157278750 |
| Fax Number: | 5157278757 |
| NPI Enumeration Date: | 04/23/2007 |
| NPI Last Update Date: | 07/10/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QR0400X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Rehabilitation |
| Taxonomy Definition: | |