Provider Demographics
NPI:1205151404
Name:CREATIVE INNOVATIONS, INC
Entity type:Organization
Organization Name:CREATIVE INNOVATIONS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:
Authorized Official - First Name:RONALDA (RONNIE)
Authorized Official - Middle Name:LEEANN
Authorized Official - Last Name:LOWELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:207-320-3232
Mailing Address - Street 1:275 BRYANT ROAD
Mailing Address - Street 2:
Mailing Address - City:BUCKFIELD
Mailing Address - State:ME
Mailing Address - Zip Code:04220
Mailing Address - Country:US
Mailing Address - Phone:207-320-3232
Mailing Address - Fax:207-336-2552
Practice Address - Street 1:275 BRYANT RD
Practice Address - Street 2:
Practice Address - City:BUCKFIELD
Practice Address - State:ME
Practice Address - Zip Code:04220-4113
Practice Address - Country:US
Practice Address - Phone:207-320-3232
Practice Address - Fax:207-336-2552
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-30
Last Update Date:2010-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME3002406253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care