Provider Demographics
NPI:1598828147
Name:CREATIVE SUPPORTS, INC
Entity Type:Organization
Organization Name:CREATIVE SUPPORTS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:DANA
Authorized Official - Middle Name:LANICE
Authorized Official - Last Name:GUYER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:816-452-6194
Mailing Address - Street 1:PO BOX 10586
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64188-0586
Mailing Address - Country:US
Mailing Address - Phone:816-452-6194
Mailing Address - Fax:816-454-3211
Practice Address - Street 1:1511 NE PARVIN RD
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64116-2304
Practice Address - Country:US
Practice Address - Phone:816-452-6194
Practice Address - Fax:816-454-3211
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities