Kreative Kinnectionz Youth Outreach Inc.

Primary specialty

Case Management AgencyTaxonomy code 251B00000X

Legal business name

KREATIVE KINNECTIONZ YOUTH OUTREACH INC.

Practice address

4137 Sauk TRL Ste 116
Richton Park, IL 60471-1253

Phone

(773) 746-2063

NPI assigned

Mar 19, 2024

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Danielle Smith-Brent

Title

Executive Director

Phone

(312) 857-5143

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Danielle Devon Smith

  • Behavior Technician
  • Hammond, IN
  • NPI 1639939648

  Case Management

  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1710806400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1710806400000",
    "number": "1508626417",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4137 SAUK TRL STE 116",
            "city": "RICHTON PARK",
            "state": "IL",
            "postal_code": "604711253",
            "telephone_number": "773-746-2063"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4137 SAUK TRL STE 116",
            "city": "RICHTON PARK",
            "state": "IL",
            "postal_code": "604711253",
            "telephone_number": "773-746-2063"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KREATIVE KINNECTIONZ YOUTH OUTREACH INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-03-19",
        "last_updated": "2024-03-19",
        "certification_date": "2024-03-19",
        "status": "A",
        "authorized_official_last_name": "SMITH-BRENT",
        "authorized_official_first_name": "DANIELLE",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "312-857-5143"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Providers in Richton Park, IL by specialty
• Case Management Agency in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.