Provider Demographics
NPI:1417001090
Name:CREATIVE HEALTH CARE SERVICES, INC.
Entity Type:Organization
Organization Name:CREATIVE HEALTH CARE SERVICES, INC.
Other - Org Name:SUNRISE HEALTH AND HOSPICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:TARIK
Authorized Official - Middle Name:
Authorized Official - Last Name:SHIRIF
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-926-0133
Mailing Address - Street 1:105 N PASADENA ST
Mailing Address - Street 2:SUITE B
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85233-5013
Mailing Address - Country:US
Mailing Address - Phone:480-926-0133
Mailing Address - Fax:480-926-6377
Practice Address - Street 1:1840 E UNIVERSITY DR
Practice Address - Street 2:SUITE 2
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85203-8237
Practice Address - Country:US
Practice Address - Phone:480-246-3500
Practice Address - Fax:480-246-3510
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-22
Last Update Date:2009-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251G00000X
AZHSPC4115251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based