Licensing Information

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Basic information

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Provider name
Elliot James
License number
4001604
Date of birth
07/07/07
Gender
Female
Race
African-American
Delaware resident since
09/10/2003
Drivers license or Delaware ID
F2837491
Email
hello@creativeenrichment.org
Phone
302-834-5259
Social Security number
448-234-3824
Marital status
Married
City
Bear, DE
Primary address
1458 Bear Corbitt Road
Zip Code
19701

Enrollment details

Desired start date
09/30/2024
Documents
Schedule
Monday - Friday
9:00am - 5:00pm

Background

Criminal record
No
Abuse or negligence
No
I am aware that Michigan Department of State Police records will be checked for information regarding criminal convictions under authority of the Good Moral Character Statute
I am aware that the Department of Health and Human Services Central Registry will be checked for information concerning substantiated child abuse and neglect
I certify that the Information I have given on the form is, to the best of my ability, true and correct
The Department may perform this check at any time while I am licensed

Fees

Application fee
$15.00
Amendment fee
$5.00
Payment method
Visa ending 4234