Provider Demographics
NPI:1841926102
Name:CREATIVE COMP SOLUTIONS LLC
Entity type:Organization
Organization Name:CREATIVE COMP SOLUTIONS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:A
Authorized Official - Last Name:CALDWELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-990-1064
Mailing Address - Street 1:1170 TREE SWALLOW DR STE 377
Mailing Address - Street 2:
Mailing Address - City:WINTER SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:32708-2826
Mailing Address - Country:US
Mailing Address - Phone:407-421-1690
Mailing Address - Fax:407-917-7095
Practice Address - Street 1:817 DOUGLAS AVE STE 177
Practice Address - Street 2:
Practice Address - City:ALTAMONTE SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:32714-5200
Practice Address - Country:US
Practice Address - Phone:888-211-8021
Practice Address - Fax:407-917-7095
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-28
Last Update Date:2023-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Multi-Specialty
No171W00000XOther Service ProvidersContractorGroup - Multi-Specialty