Provider Demographics
NPI:1033652904
Name:CREATIVE HOUSING, INC.
Entity Type:Organization
Organization Name:CREATIVE HOUSING, INC.
Other - Org Name:CREATIVE HOUSING-CREATIVE RENOVATIONS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR OF PROJECTS & DESIGN
Authorized Official - Prefix:MS
Authorized Official - First Name:CRISTY
Authorized Official - Middle Name:
Authorized Official - Last Name:BUENCONSEJO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-418-7725
Mailing Address - Street 1:2233 CITYGATE DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43219-3564
Mailing Address - Country:US
Mailing Address - Phone:614-418-7725
Mailing Address - Fax:614-418-7720
Practice Address - Street 1:2233 CITYGATE DR
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43219-3564
Practice Address - Country:US
Practice Address - Phone:614-418-7725
Practice Address - Fax:614-418-7720
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-28
Last Update Date:2016-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171W00000XOther Service ProvidersContractorGroup - Multi-Specialty
No332B00000XSuppliersDurable Medical Equipment & Medical SuppliesGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2016240Medicaid