Provider Demographics
NPI:1053859314
Name:CREATIVE ALTERNATIVES, INC
Entity Type:Organization
Organization Name:CREATIVE ALTERNATIVES, INC
Other - Org Name:MERCED RANCH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ASSISTANT EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:LISA
Authorized Official - Middle Name:
Authorized Official - Last Name:JACOBS
Authorized Official - Suffix:
Authorized Official - Credentials:MPA
Authorized Official - Phone:209-668-9361
Mailing Address - Street 1:2855 GEER RD
Mailing Address - Street 2:
Mailing Address - City:TURLOCK
Mailing Address - State:CA
Mailing Address - Zip Code:95382-1133
Mailing Address - Country:US
Mailing Address - Phone:209-668-9361
Mailing Address - Fax:
Practice Address - Street 1:2025 E SANTA FE DR
Practice Address - Street 2:
Practice Address - City:MERCED
Practice Address - State:CA
Practice Address - Zip Code:95340-4331
Practice Address - Country:US
Practice Address - Phone:209-388-9034
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MERCED RANCH
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-02-07
Last Update Date:2022-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA247200747322D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes322D00000XResidential Treatment FacilitiesResidential Treatment Facility, Emotionally Disturbed Children