| NPI | 1083363915 |
|---|---|
| Doing Business As | KIDDIEKLUBHOUSE, LLC |
| Entity Type | Organization |
| Authorized Contact | AMY CARMAN Manager 765-283-8895 |
| Organization Subpart ? | No |
| Primary Taxonomy | 385HR2055X Respite Care, Respite Care, Mental Illness, Child |
| Enumeration Date | 2022-03-18 |
| Last Update Date | 2022-03-18 |