Provider Demographics
NPI:1720210750
Name:CREATIVE INTERVENTIONS, INC
Entity Type:Organization
Organization Name:CREATIVE INTERVENTIONS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:CARLA
Authorized Official - Middle Name:Y
Authorized Official - Last Name:WRIGHT
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:404-957-8149
Mailing Address - Street 1:3114 CHEROKEE ST NW
Mailing Address - Street 2:SUITE 209
Mailing Address - City:KENNESAW
Mailing Address - State:GA
Mailing Address - Zip Code:30144-6524
Mailing Address - Country:US
Mailing Address - Phone:404-957-8149
Mailing Address - Fax:404-766-8921
Practice Address - Street 1:3114 CHEROKEE ST NW
Practice Address - Street 2:SUITE 209
Practice Address - City:KENNESAW
Practice Address - State:GA
Practice Address - Zip Code:30144-6524
Practice Address - Country:US
Practice Address - Phone:404-957-8149
Practice Address - Fax:404-766-8921
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-08
Last Update Date:2009-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health