Provider Demographics
NPI:1780217265
Name:UNIQUE CREATIVE ABILITIES
Entity Type:Organization
Organization Name:UNIQUE CREATIVE ABILITIES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:LAQUEASHA
Authorized Official - Middle Name:
Authorized Official - Last Name:HAYES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:319-541-0973
Mailing Address - Street 1:1129 WINCHESTER LN
Mailing Address - Street 2:
Mailing Address - City:NORTH LIBERTY
Mailing Address - State:IA
Mailing Address - Zip Code:52317-9162
Mailing Address - Country:US
Mailing Address - Phone:319-541-0973
Mailing Address - Fax:
Practice Address - Street 1:1129 WINCHESTER LN
Practice Address - Street 2:
Practice Address - City:NORTH LIBERTY
Practice Address - State:IA
Practice Address - Zip Code:52317-9162
Practice Address - Country:US
Practice Address - Phone:319-541-0973
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-12
Last Update Date:2020-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes253Z00000XAgenciesIn Home Supportive Care
No347C00000XTransportation ServicesPrivate VehicleGroup - Multi-Specialty
No376J00000XNursing Service Related ProvidersHomemakerGroup - Multi-Specialty
No372600000XNursing Service Related ProvidersAdult CompanionGroup - Multi-Specialty