Provider Demographics
NPI:1750521779
Name:CREATIVE HEALTH SOLUTIONS LLC
Entity type:Organization
Organization Name:CREATIVE HEALTH SOLUTIONS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF OPERATING OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:
Authorized Official - Last Name:FEINGOLD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:703-910-5006
Mailing Address - Street 1:3900 JERMANTOWN RD STE 250
Mailing Address - Street 2:
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22030-4946
Mailing Address - Country:US
Mailing Address - Phone:703-910-5006
Mailing Address - Fax:888-314-6706
Practice Address - Street 1:3900 JERMANTOWN RD STE 250
Practice Address - Street 2:
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22030-4946
Practice Address - Country:US
Practice Address - Phone:703-910-5006
Practice Address - Fax:888-314-6706
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-03
Last Update Date:2016-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA1003854381261QM1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty