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General NPI Number Information
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NPI Number | 1235092487
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Entity Type | Organization
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Legal Business Name | CREATING IMPACT ENTERPRISES, LLC
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Dates
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Enumeration Date | 12/04/2025
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Last Update Date | 12/04/2025
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Provider Practice Location Address
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Address Line | 945 E ELLET ST
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City | PHILADELPHIA
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State | PA
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Zip | 19150-3506
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Country | US
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Telephone | 267-978-9177
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Fax |
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Provider Business Mailing Address
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Address Line | 945 E ELLET ST
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City | PHILADELPHIA
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State | PA
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Zip | 19150-3506
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Country | US
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Telephone | 267-978-9177
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MARTHA WATKINS WATKINS
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Credential |
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Telephone | 267-978-9177
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 177F00000X
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Taxonomy Name | Lodging Provider
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License Number |
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License Number State |
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