MEDICARE: JAZZY KIDZ DAYCARE CENTER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251C00000X	Developmentally Disabled Services Day Training Agency	2651849	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1679608335
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JAZZY KIDZ DAYCARE CENTER

Provider Business Mailing Address
First Line	:	2140 CLEVELAND AVE NW
Second Line	:	2212 CLEVELAND AVE. N.W.
City	:	CANTON
State	:	OH
Zip	:	44709-3607
Country	:	US
Telephone Number	:	330-455-5175
Fax Number	:	330-455-5142

Provider Business Practice Location Address
First Line	:	2140 CLEVELAND AVE NW
Second Line	:	2212 CLEVELAND AVE. N.W.
City	:	CANTON
State	:	OH
Zip	:	44709-3607
Country	:	US
Telephone Number	:	330-455-5175
Fax Number	:	330-455-5142

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	MRS. TRENA Y CURTIS
Credential	:
Telephone Number	:	330-455-5175

Provider Enumeration Date	:	02/22/2007
Last Update Date	:	08/22/2020

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