Provider Demographics
NPI:1851663199
Name:CREATIVE HEALTH SOLUTIONS
Entity Type:Organization
Organization Name:CREATIVE HEALTH SOLUTIONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHANNON
Authorized Official - Middle Name:
Authorized Official - Last Name:SPRINKLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:765-465-3203
Mailing Address - Street 1:102 OVERLOOK DR
Mailing Address - Street 2:
Mailing Address - City:WINTER HAVEN
Mailing Address - State:FL
Mailing Address - Zip Code:33884-1600
Mailing Address - Country:US
Mailing Address - Phone:863-370-5142
Mailing Address - Fax:
Practice Address - Street 1:102 OVERLOOK DR
Practice Address - Street 2:
Practice Address - City:WINTER HAVEN
Practice Address - State:FL
Practice Address - Zip Code:33884-1600
Practice Address - Country:US
Practice Address - Phone:863-370-5142
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-02
Last Update Date:2012-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOTA7656261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service