Provider Demographics
NPI:1508538810
Name:CREATIVE HEALTH CARE MANAGEMENT LLC
Entity Type:Organization
Organization Name:CREATIVE HEALTH CARE MANAGEMENT LLC
Other - Org Name:VERTIS THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:REIMBURSEMENT
Authorized Official - Prefix:
Authorized Official - First Name:MISTY
Authorized Official - Middle Name:D
Authorized Official - Last Name:BEAUDRY-ZOBEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:317-204-3736
Mailing Address - Street 1:10 S 9TH ST STE 4
Mailing Address - Street 2:
Mailing Address - City:NOBLESVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46060-2631
Mailing Address - Country:US
Mailing Address - Phone:765-524-3946
Mailing Address - Fax:
Practice Address - Street 1:6600 POPLAR SPRINGS DR
Practice Address - Street 2:
Practice Address - City:MERIDIAN
Practice Address - State:MS
Practice Address - Zip Code:39305-1105
Practice Address - Country:US
Practice Address - Phone:601-482-5561
Practice Address - Fax:317-449-5783
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-05
Last Update Date:2023-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
No261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitationGroup - Multi-Specialty