Provider Demographics
NPI:1376692723
Name:CREATIVE OPTIONS & EMPLOYMENT, LLC
Entity Type:Organization
Organization Name:CREATIVE OPTIONS & EMPLOYMENT, LLC
Other - Org Name:CREATIVE OPTIONS
Other - Org Type:Other Name
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ALANA
Authorized Official - Middle Name:
Authorized Official - Last Name:POWELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-779-3890
Mailing Address - Street 1:4705 QUEENSBURY RD
Mailing Address - Street 2:
Mailing Address - City:RIVERDALE
Mailing Address - State:MD
Mailing Address - Zip Code:20737-1920
Mailing Address - Country:US
Mailing Address - Phone:301-779-3890
Mailing Address - Fax:866-891-8163
Practice Address - Street 1:4705 QUEENSBURY RD
Practice Address - Street 2:
Practice Address - City:RIVERDALE
Practice Address - State:MD
Practice Address - Zip Code:20737-1920
Practice Address - Country:US
Practice Address - Phone:301-779-3890
Practice Address - Fax:866-891-8163
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-08
Last Update Date:2008-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC035752900Medicaid