MEDICARE: CREATIVE BEGINNINGS, INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251S00000X	Community/Behavioral Health Agency	3443	CO

General Provider Information

NPI Number	:	1912077033
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CREATIVE BEGINNINGS, INC

Provider Business Mailing Address
First Line	:	7100 BROADWAY
Second Line	:	2J
City	:	DENVER
State	:	CO
Zip	:	80221-2915
Country	:	US
Telephone Number	:	303-412-9600
Fax Number	:	303-412-9611

Provider Business Practice Location Address
First Line	:	7100 BROADWAY
Second Line	:	2J
City	:	DENVER
State	:	CO
Zip	:	80221-2915
Country	:	US
Telephone Number	:	303-412-9600
Fax Number	:	303-412-9611

Authorized Official
Title or Position	:	CLINICAL DIRECTOR
Name	:	MR. AARON JOSEPH CORDOVA
Credential	:	M.A.
Telephone Number	:	303-412-9600

Provider Enumeration Date	:	11/08/2006
Last Update Date	:	08/22/2020

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