Provider Demographics
NPI:1427590991
Name:JESS'S KIDS, INC.
Entity type:Organization
Organization Name:JESS'S KIDS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:DAWN
Authorized Official - Last Name:OMEARA
Authorized Official - Suffix:
Authorized Official - Credentials:MSED
Authorized Official - Phone:516-662-6141
Mailing Address - Street 1:3063 BROWER AVE
Mailing Address - Street 2:
Mailing Address - City:OCEANSIDE
Mailing Address - State:NY
Mailing Address - Zip Code:11572-4411
Mailing Address - Country:US
Mailing Address - Phone:516-608-9851
Mailing Address - Fax:516-608-9851
Practice Address - Street 1:3063 BROWER AVE
Practice Address - Street 2:
Practice Address - City:OCEANSIDE
Practice Address - State:NY
Practice Address - Zip Code:11572-4411
Practice Address - Country:US
Practice Address - Phone:516-608-9851
Practice Address - Fax:516-608-9851
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-15
Last Update Date:2016-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY252Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency