Provider Demographics
NPI:1184456659
Name:JONI PENDERGRASS LOVE, LEARN, AND PLAY
Entity type:Organization
Organization Name:JONI PENDERGRASS LOVE, LEARN, AND PLAY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JONI
Authorized Official - Middle Name:CRANFORD
Authorized Official - Last Name:PENDERGRASS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:843-453-3106
Mailing Address - Street 1:PO BOX 571
Mailing Address - Street 2:
Mailing Address - City:HARTSVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29551-0571
Mailing Address - Country:US
Mailing Address - Phone:843-453-3106
Mailing Address - Fax:
Practice Address - Street 1:1455 NOTTINGHAM DR
Practice Address - Street 2:
Practice Address - City:HARTSVILLE
Practice Address - State:SC
Practice Address - Zip Code:29550-8585
Practice Address - Country:US
Practice Address - Phone:843-453-3106
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-14
Last Update Date:2024-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency