| Create It Kids Club, Llc. | |
|
1425 Market Blvd Ste 530-251 Roswell GA 30076-6708 | |
| (678) 235-4333 | |
| Not Available |
| Full Name | Create It Kids Club, Llc. |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 1425 Market Blvd Ste 530-251, Roswell, Georgia |
| Authorized Official Name and Position | Tameka Anderson (BEHAVIOR SPECIALIST) |
| Authorized Official Contact | 6782354333 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Create It Kids Club, Llc. 1425 Market Blvd Ste 530-251 Roswell GA 30076-6708 Ph: (678) 235-4333 | Create It Kids Club, Llc. 1425 Market Blvd Ste 530-251 Roswell GA 30076-6708 Ph: (678) 235-4333 |
| NPI Number | 1518458249 |
|---|---|
| Provider Enumeration Date | 05/29/2018 |
| Last Update Date | 05/29/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518458249 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| 385HR2050X | Respite Care - Respite Care Camp | (* (Not Available)) | Secondary |
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