Provider Demographics
NPI:1255705893
Name:THE LEARNING LADDER OF KANKAKEE COUNTY
Entity type:Organization
Organization Name:THE LEARNING LADDER OF KANKAKEE COUNTY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DEVELOPMENTAL THERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:LYN
Authorized Official - Last Name:MALLARD
Authorized Official - Suffix:
Authorized Official - Credentials:BACHELORS
Authorized Official - Phone:815-671-7092
Mailing Address - Street 1:598 SPRING PARK LOOP
Mailing Address - Street 2:
Mailing Address - City:BOURBONNAIS
Mailing Address - State:IL
Mailing Address - Zip Code:60914-4968
Mailing Address - Country:US
Mailing Address - Phone:815-671-7092
Mailing Address - Fax:888-978-5139
Practice Address - Street 1:598 SPRING PARK LOOP
Practice Address - Street 2:
Practice Address - City:BOURBONNAIS
Practice Address - State:IL
Practice Address - Zip Code:60914-4968
Practice Address - Country:US
Practice Address - Phone:815-671-7092
Practice Address - Fax:888-978-5139
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-11-19
Last Update Date:2015-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency