Provider Demographics
NPI:1093219982
Name:CREATIVE INTERVENTIONS, LLC
Entity Type:Organization
Organization Name:CREATIVE INTERVENTIONS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:INSURANCE COORDINATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:ANA
Authorized Official - Middle Name:
Authorized Official - Last Name:FABIAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:860-413-9538
Mailing Address - Street 1:15 SCHOOL ST
Mailing Address - Street 2:
Mailing Address - City:EAST GRANBY
Mailing Address - State:CT
Mailing Address - Zip Code:06026-9770
Mailing Address - Country:US
Mailing Address - Phone:860-413-9538
Mailing Address - Fax:
Practice Address - Street 1:835 BLOOMFIELD AVE
Practice Address - Street 2:
Practice Address - City:WINDSOR
Practice Address - State:CT
Practice Address - Zip Code:06095-2363
Practice Address - Country:US
Practice Address - Phone:860-413-9538
Practice Address - Fax:860-838-4241
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-23
Last Update Date:2023-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health