Provider Demographics
NPI:1750601373
Name:CREATIVE SOLUTIONS 4 KIDS AND FAMILIES LLC
Entity type:Organization
Organization Name:CREATIVE SOLUTIONS 4 KIDS AND FAMILIES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER/MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:DEVINA
Authorized Official - Middle Name:
Authorized Official - Last Name:CRUICKSHANK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-832-3602
Mailing Address - Street 1:4700 SHERIDAN ST
Mailing Address - Street 2:SUITE J
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33021-3420
Mailing Address - Country:US
Mailing Address - Phone:954-832-3602
Mailing Address - Fax:954-272-7525
Practice Address - Street 1:4700 SHERIDAN ST
Practice Address - Street 2:SUITE J
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33021-3420
Practice Address - Country:US
Practice Address - Phone:954-832-3602
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-04
Last Update Date:2012-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health