Provider Demographics
NPI:1679022172
Name:CREATING VICTORIES
Entity Type:Organization
Organization Name:CREATING VICTORIES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:SANDRA
Authorized Official - Middle Name:CARTER
Authorized Official - Last Name:PYANT
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:240-286-1766
Mailing Address - Street 1:PO BOX 441966
Mailing Address - Street 2:
Mailing Address - City:FORT WASHINGTON
Mailing Address - State:MD
Mailing Address - Zip Code:20749-1966
Mailing Address - Country:US
Mailing Address - Phone:240-286-1766
Mailing Address - Fax:240-269-0230
Practice Address - Street 1:3453 W SIEBENTHALER AVE
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45406-1829
Practice Address - Country:US
Practice Address - Phone:240-286-1766
Practice Address - Fax:240-269-0230
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-25
Last Update Date:2016-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health