Provider Demographics
NPI:1871246751
Name:DEVELOPING CREATIVE ACTIVITIES, LLC.
Entity Type:Organization
Organization Name:DEVELOPING CREATIVE ACTIVITIES, LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:KERLEEN
Authorized Official - Middle Name:V
Authorized Official - Last Name:CLAXTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:321-588-9364
Mailing Address - Street 1:1850 N ALAFAYA TRL STE C
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32826-4745
Mailing Address - Country:US
Mailing Address - Phone:321-588-9364
Mailing Address - Fax:
Practice Address - Street 1:1850 N ALAFAYA TRL STE C
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32826-4745
Practice Address - Country:US
Practice Address - Phone:321-588-9364
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-31
Last Update Date:2022-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes175T00000XOther Service ProvidersPeer SpecialistGroup - Single Specialty
No101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty