Provider Demographics
NPI:1225585193
Name:CENTER FOR CREATIVE VALUES
Entity Type:Organization
Organization Name:CENTER FOR CREATIVE VALUES
Other - Org Name:YES INITIATIVE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PROGRAM DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:KAY
Authorized Official - Middle Name:
Authorized Official - Last Name:ATOLOYE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:443-929-8315
Mailing Address - Street 1:515 E JOPPA RD STE 100
Mailing Address - Street 2:
Mailing Address - City:TOWSON
Mailing Address - State:MD
Mailing Address - Zip Code:21286-1804
Mailing Address - Country:US
Mailing Address - Phone:443-929-8315
Mailing Address - Fax:
Practice Address - Street 1:515 E JOPPA RD STE 100
Practice Address - Street 2:
Practice Address - City:TOWSON
Practice Address - State:MD
Practice Address - Zip Code:21286-1804
Practice Address - Country:US
Practice Address - Phone:443-929-8315
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CENTER FOR CREATIVE VALUES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-09-08
Last Update Date:2022-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health