Provider Demographics
NPI:1639680176
Name:CREATIVE HANDS IN MOTION LLC
Entity Type:Organization
Organization Name:CREATIVE HANDS IN MOTION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/ OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LATOSHA
Authorized Official - Middle Name:
Authorized Official - Last Name:FORD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:863-614-3167
Mailing Address - Street 1:2405 SMOKE RD
Mailing Address - Street 2:
Mailing Address - City:AUBURNDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33823-9593
Mailing Address - Country:US
Mailing Address - Phone:863-614-3167
Mailing Address - Fax:
Practice Address - Street 1:2405 SMOKE RD
Practice Address - Street 2:
Practice Address - City:AUBURNDALE
Practice Address - State:FL
Practice Address - Zip Code:33823
Practice Address - Country:US
Practice Address - Phone:863-614-3167
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CREATIVE HANDS IN MOTION LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-10-23
Last Update Date:2022-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QD1600XAmbulatory Health Care FacilitiesClinic/CenterDevelopmental DisabilitiesGroup - Single Specialty
No174200000XOther Service ProvidersMealsGroup - Single Specialty
No253Z00000XAgenciesIn Home Supportive CareGroup - Single Specialty