Provider Demographics
NPI:1669169173
Name:CREO THERAPY SOLUTIONS
Entity type:Organization
Organization Name:CREO THERAPY SOLUTIONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MARVAH
Authorized Official - Middle Name:
Authorized Official - Last Name:D'AQUINO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-930-0014
Mailing Address - Street 1:1717 W NORTHERN AVE STE 207A
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85021-5471
Mailing Address - Country:US
Mailing Address - Phone:602-935-7841
Mailing Address - Fax:
Practice Address - Street 1:1717 W NORTHERN AVE STE 207A
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85021-5471
Practice Address - Country:US
Practice Address - Phone:602-935-7841
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-24
Last Update Date:2023-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health