Provider Demographics
NPI:1275757809
Name:CREATIVE CHOICES
Entity Type:Organization
Organization Name:CREATIVE CHOICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ROGER
Authorized Official - Middle Name:
Authorized Official - Last Name:MEYER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:563-557-8979
Mailing Address - Street 1:909 MAIN ST
Mailing Address - Street 2:SUITE 669
Mailing Address - City:DUBUQUE
Mailing Address - State:IA
Mailing Address - Zip Code:52001-6712
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:909 MAIN ST
Practice Address - Street 2:SUITE 669
Practice Address - City:DUBUQUE
Practice Address - State:IA
Practice Address - Zip Code:52001-6712
Practice Address - Country:US
Practice Address - Phone:563-577-8979
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty