Provider Demographics
NPI:1164821419
Name:CREATIVE CARE SOLUTIONS, LLC
Entity Type:Organization
Organization Name:CREATIVE CARE SOLUTIONS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SECRETARY
Authorized Official - Prefix:
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:CHERRY
Authorized Official - Last Name:WILKIN
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:812-219-8341
Mailing Address - Street 1:455 E WYLIE FARM RD
Mailing Address - Street 2:
Mailing Address - City:BLOOMINGTON
Mailing Address - State:IN
Mailing Address - Zip Code:47401-4591
Mailing Address - Country:US
Mailing Address - Phone:812-219-8341
Mailing Address - Fax:
Practice Address - Street 1:455 E WYLIE FARM RD
Practice Address - Street 2:
Practice Address - City:BLOOMINGTON
Practice Address - State:IN
Practice Address - Zip Code:47401-4591
Practice Address - Country:US
Practice Address - Phone:812-219-8341
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-21
Last Update Date:2014-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN34004227A251B00000X, 251S00000X, 253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No251B00000XAgenciesCase Management
No253Z00000XAgenciesIn Home Supportive Care