Provider Demographics
NPI:1942955562
Name:CREATIVE SPIRIT CENTER INC
Entity Type:Organization
Organization Name:CREATIVE SPIRIT CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:J
Authorized Official - Last Name:VOSEJPKA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:989-837-1885
Mailing Address - Street 1:1517 BAYLISS ST
Mailing Address - Street 2:
Mailing Address - City:MIDLAND
Mailing Address - State:MI
Mailing Address - Zip Code:48640-5509
Mailing Address - Country:US
Mailing Address - Phone:989-837-1885
Mailing Address - Fax:
Practice Address - Street 1:1517 BAYLISS ST
Practice Address - Street 2:
Practice Address - City:MIDLAND
Practice Address - State:MI
Practice Address - Zip Code:48640-5509
Practice Address - Country:US
Practice Address - Phone:989-837-1885
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-14
Last Update Date:2022-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health