Provider Demographics
NPI:1255815486
Name:LITTLE HANDS AND CREATIONS LLC
Entity type:Organization
Organization Name:LITTLE HANDS AND CREATIONS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CE)
Authorized Official - Prefix:
Authorized Official - First Name:NYESHA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:LITTLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:862-241-0147
Mailing Address - Street 1:1219 LIBERTY AVE
Mailing Address - Street 2:
Mailing Address - City:HILLSIDE
Mailing Address - State:NJ
Mailing Address - Zip Code:07205-1214
Mailing Address - Country:US
Mailing Address - Phone:862-241-0147
Mailing Address - Fax:
Practice Address - Street 1:1219 LIBERTY AVE
Practice Address - Street 2:
Practice Address - City:HILLSIDE
Practice Address - State:NJ
Practice Address - Zip Code:07205-2055
Practice Address - Country:US
Practice Address - Phone:862-241-0147
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-24
Last Update Date:2019-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes253Z00000XAgenciesIn Home Supportive Care
No103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty
No251B00000XAgenciesCase ManagementGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1255815486Medicaid