Provider Demographics
NPI:1265819684
Name:KIP ENTERPRISE, INC.
Entity type:Organization
Organization Name:KIP ENTERPRISE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER
Authorized Official - Prefix:MS
Authorized Official - First Name:KESCIA
Authorized Official - Middle Name:I
Authorized Official - Last Name:PRIOLEAU
Authorized Official - Suffix:
Authorized Official - Credentials:MSED
Authorized Official - Phone:917-724-6257
Mailing Address - Street 1:306 W 114TH ST
Mailing Address - Street 2:#1B
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10026-2736
Mailing Address - Country:US
Mailing Address - Phone:917-724-6257
Mailing Address - Fax:
Practice Address - Street 1:306 W 114TH ST
Practice Address - Street 2:#1B
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10026-2736
Practice Address - Country:US
Practice Address - Phone:917-724-6257
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-05
Last Update Date:2015-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY4571417252Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency