Provider Demographics
NPI:1609458835
Name:CREATIVE OPTIONS FOR HEALING
Entity Type:Organization
Organization Name:CREATIVE OPTIONS FOR HEALING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MISS
Authorized Official - First Name:NOLITA
Authorized Official - Middle Name:RENA
Authorized Official - Last Name:BERGER
Authorized Official - Suffix:
Authorized Official - Credentials:MA,LCDC II
Authorized Official - Phone:614-946-9711
Mailing Address - Street 1:1002 E LIVINGSTON AVE APT A
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43205-2714
Mailing Address - Country:US
Mailing Address - Phone:614-946-9711
Mailing Address - Fax:
Practice Address - Street 1:1002 E LIVINGSTON AVE APT A
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43205-2714
Practice Address - Country:US
Practice Address - Phone:614-946-9711
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-27
Last Update Date:2021-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder