Provider Demographics
NPI:1235810102
Name:CREATIVE SUPPORTIVE SOLUTIONS
Entity Type:Organization
Organization Name:CREATIVE SUPPORTIVE SOLUTIONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:LOREANA
Authorized Official - Middle Name:MONIQUE
Authorized Official - Last Name:THOMAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:603-534-6719
Mailing Address - Street 1:11 N CRANBERRY LN
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NH
Mailing Address - Zip Code:03867-5219
Mailing Address - Country:US
Mailing Address - Phone:207-703-3958
Mailing Address - Fax:
Practice Address - Street 1:11 N CRANBERRY LN
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03867-5219
Practice Address - Country:US
Practice Address - Phone:603-534-6719
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-25
Last Update Date:2023-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management