Provider Demographics
NPI:1447828579
Name:KRE8TIVE KIDS VOYAGE LLC
Entity type:Organization
Organization Name:KRE8TIVE KIDS VOYAGE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:MARGARET
Authorized Official - Last Name:GALTIERI
Authorized Official - Suffix:
Authorized Official - Credentials:MSED
Authorized Official - Phone:718-812-6589
Mailing Address - Street 1:JESSICA GALTIERI
Mailing Address - Street 2:841BECKMAN DRIVE
Mailing Address - City:BELLMORE
Mailing Address - State:NY
Mailing Address - Zip Code:11710
Mailing Address - Country:US
Mailing Address - Phone:718-812-6589
Mailing Address - Fax:
Practice Address - Street 1:JESSICA GALTIERI
Practice Address - Street 2:841BECKMAN DRIVE
Practice Address - City:BELLMORE
Practice Address - State:NY
Practice Address - Zip Code:11710
Practice Address - Country:US
Practice Address - Phone:718-812-6589
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-15
Last Update Date:2021-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty