Provider Demographics
NPI:1346317989
Name:CREATION LIVING CENTER
Entity Type:Organization
Organization Name:CREATION LIVING CENTER
Other - Org Name:HOPE ADODO
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:HOPE
Authorized Official - Middle Name:EBELE
Authorized Official - Last Name:ADODO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-773-0808
Mailing Address - Street 1:16325 WESTHEIMER ROAD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77082
Mailing Address - Country:US
Mailing Address - Phone:713-773-0808
Mailing Address - Fax:713-773-0941
Practice Address - Street 1:16325 WESTHEIMER ROAD
Practice Address - Street 2:SUITE 101
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77082
Practice Address - Country:US
Practice Address - Phone:713-773-0808
Practice Address - Fax:713-773-0941
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-29
Last Update Date:2021-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251J00000XAgenciesNursing CareGroup - Single Specialty
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX185501701Medicaid