Provider Demographics
NPI:1821744111
Name:CREATIVE CARE SERVICES INC.
Entity Type:Organization
Organization Name:CREATIVE CARE SERVICES INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:RACHELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:JACQUES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-229-3761
Mailing Address - Street 1:2393 S CONGRESS AVE STE 200
Mailing Address - Street 2:
Mailing Address - City:PALM SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33406-7628
Mailing Address - Country:US
Mailing Address - Phone:561-229-3761
Mailing Address - Fax:
Practice Address - Street 1:2393 S CONGRESS AVE STE 200
Practice Address - Street 2:
Practice Address - City:PALM SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33406-7628
Practice Address - Country:US
Practice Address - Phone:561-229-3761
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-24
Last Update Date:2022-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NAOtherNA