Provider Demographics
NPI:1679608335
Name:JAZZY KIDZ DAYCARE CENTER
Entity type:Organization
Organization Name:JAZZY KIDZ DAYCARE CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:TRENA
Authorized Official - Middle Name:Y
Authorized Official - Last Name:CURTIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:330-455-5175
Mailing Address - Street 1:2140 CLEVELAND AVE NW
Mailing Address - Street 2:2212 CLEVELAND AVE. N.W.
Mailing Address - City:CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44709-3607
Mailing Address - Country:US
Mailing Address - Phone:330-455-5175
Mailing Address - Fax:330-455-5142
Practice Address - Street 1:2140 CLEVELAND AVE NW
Practice Address - Street 2:2212 CLEVELAND AVE. N.W.
Practice Address - City:CANTON
Practice Address - State:OH
Practice Address - Zip Code:44709-3607
Practice Address - Country:US
Practice Address - Phone:330-455-5175
Practice Address - Fax:330-455-5142
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2651849251C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2651849Medicaid