Provider Demographics
NPI:1245381656
Name:CREATIVE BLESSINGS HOME HEALTHCARE AGENCY INC
Entity Type:Organization
Organization Name:CREATIVE BLESSINGS HOME HEALTHCARE AGENCY INC
Other - Org Name:CREATIVE BLESSINGS HOME HEALTHCARE AGENCY INC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:AMANDA
Authorized Official - Middle Name:DINETH
Authorized Official - Last Name:ROGERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:910-527-6384
Mailing Address - Street 1:PO BOX 48416
Mailing Address - Street 2:
Mailing Address - City:CUMBERLAND
Mailing Address - State:NC
Mailing Address - Zip Code:28331-8416
Mailing Address - Country:US
Mailing Address - Phone:910-527-6384
Mailing Address - Fax:910-221-9871
Practice Address - Street 1:2018 FORT BRAGG RD
Practice Address - Street 2:SUITE 114-B
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28303-7037
Practice Address - Country:US
Practice Address - Phone:910-221-4467
Practice Address - Fax:910-221-9871
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care