Provider Demographics
NPI:1114100351
Name:CREATIVE HOME CARE, INC.
Entity Type:Organization
Organization Name:CREATIVE HOME CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:YASSER
Authorized Official - Middle Name:
Authorized Official - Last Name:ESKANDER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-210-4000
Mailing Address - Street 1:101 W BIG BEAVER RD
Mailing Address - Street 2:SUITE 1442
Mailing Address - City:TROY
Mailing Address - State:MI
Mailing Address - Zip Code:48084-5253
Mailing Address - Country:US
Mailing Address - Phone:248-210-4000
Mailing Address - Fax:
Practice Address - Street 1:101 W BIG BEAVER RD
Practice Address - Street 2:SUITE 1442
Practice Address - City:TROY
Practice Address - State:MI
Practice Address - Zip Code:48084-5253
Practice Address - Country:US
Practice Address - Phone:248-210-4000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-11
Last Update Date:2007-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health