| Super Kids Club Llc | |
|
898 Ethan Allen Hwy Suite 2 Ridgefield CT 06877-2813 | |
| (203) 431-9150 | |
| Not Available |
| Full Name | Super Kids Club Llc |
|---|---|
| Speciality | Counselor |
| Location | 898 Ethan Allen Hwy, Ridgefield, Connecticut |
| Authorized Official Name and Position | Nancy Widdows (DIRECTOR) |
| Authorized Official Contact | 2034319150 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Super Kids Club Llc 898 Ethan Allen Hwy Suite 2 Ridgefield CT 06877-2813 Ph: (203) 431-9150 | Super Kids Club Llc 898 Ethan Allen Hwy Suite 2 Ridgefield CT 06877-2813 Ph: (203) 431-9150 |
| NPI Number | 1134396880 |
|---|---|
| Provider Enumeration Date | 05/13/2008 |
| Last Update Date | 05/13/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134396880 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101Y00000X | Counselor | (* (Not Available)) | Primary |
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