Provider Demographics
NPI:1558733865
Name:KHIRO KREATIONS LLC
Entity Type:Organization
Organization Name:KHIRO KREATIONS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GLENDA
Authorized Official - Middle Name:JOYCE
Authorized Official - Last Name:PINKNEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-362-1236
Mailing Address - Street 1:1002B S CHURCH AVE
Mailing Address - Street 2:#18412
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33679-9001
Mailing Address - Country:US
Mailing Address - Phone:813-362-1236
Mailing Address - Fax:
Practice Address - Street 1:6511 RUNNINGWOODS DR
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33634-4721
Practice Address - Country:US
Practice Address - Phone:813-352-5764
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-26
Last Update Date:2015-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
No385HR2060XRespite Care FacilityRespite CareRespite Care, Intellectual and/or Developmental Disabilities, Child