Provider Demographics
NPI:1083865372
Name:CREATIVE LIVING SOLUTIONS, INC.
Entity Type:Organization
Organization Name:CREATIVE LIVING SOLUTIONS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROGRAM DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:D'ANA
Authorized Official - Middle Name:EVETTE
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:GSW
Authorized Official - Phone:504-361-5277
Mailing Address - Street 1:3501 HOLIDAY DR
Mailing Address - Street 2:#408
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70114-8202
Mailing Address - Country:US
Mailing Address - Phone:504-361-5277
Mailing Address - Fax:504-361-5297
Practice Address - Street 1:3501 HOLIDAY DR
Practice Address - Street 2:#408
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70114-8202
Practice Address - Country:US
Practice Address - Phone:504-361-5277
Practice Address - Fax:504-361-5297
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-04
Last Update Date:2008-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA15085253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care