Provider Demographics
NPI:1881353639
Name:SO CREATIVE LIVING PLANS, LLC
Entity type:Organization
Organization Name:SO CREATIVE LIVING PLANS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RAS JAHLANI
Authorized Official - Middle Name:
Authorized Official - Last Name:BEN-LEVI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-783-0428
Mailing Address - Street 1:1761 PARSONS AVE APT B
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43207-2293
Mailing Address - Country:US
Mailing Address - Phone:614-783-0428
Mailing Address - Fax:
Practice Address - Street 1:1761 PARSONS AVE APT B
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43207-2293
Practice Address - Country:US
Practice Address - Phone:614-783-0428
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-09
Last Update Date:2021-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health