Provider Demographics
NPI:1548414626
Name:CREATIVE HEALTH SOLUTIONS
Entity Type:Organization
Organization Name:CREATIVE HEALTH SOLUTIONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COTA
Authorized Official - Prefix:MS
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:ROUSCULP
Authorized Official - Suffix:
Authorized Official - Credentials:COTA
Authorized Official - Phone:574-208-0020
Mailing Address - Street 1:54233 LANDES DR
Mailing Address - Street 2:
Mailing Address - City:OSCEOLA
Mailing Address - State:IN
Mailing Address - Zip Code:46561-9017
Mailing Address - Country:US
Mailing Address - Phone:574-208-0020
Mailing Address - Fax:
Practice Address - Street 1:54233 LANDES DR
Practice Address - Street 2:
Practice Address - City:OSCEOLA
Practice Address - State:IN
Practice Address - Zip Code:46561-9017
Practice Address - Country:US
Practice Address - Phone:574-208-0020
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-16
Last Update Date:2008-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN32001280A314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility