Provider Demographics
NPI:1497592992
Name:KREATIVE KARE HOMES
Entity type:Organization
Organization Name:KREATIVE KARE HOMES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIEF OPERATING OFFICER
Authorized Official - Prefix:MRS
Authorized Official - First Name:DARESHA
Authorized Official - Middle Name:R
Authorized Official - Last Name:LAKEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-241-5709
Mailing Address - Street 1:137 RHUIDEAN CT
Mailing Address - Street 2:
Mailing Address - City:TROUTMAN
Mailing Address - State:NC
Mailing Address - Zip Code:28166-0249
Mailing Address - Country:US
Mailing Address - Phone:704-241-5709
Mailing Address - Fax:
Practice Address - Street 1:534 ELK SPUR ST
Practice Address - Street 2:
Practice Address - City:ELKIN
Practice Address - State:NC
Practice Address - Zip Code:28621-3206
Practice Address - Country:US
Practice Address - Phone:704-241-5709
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-11
Last Update Date:2025-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
No253J00000XAgenciesFoster Care Agency
No253Z00000XAgenciesIn Home Supportive Care
No320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities