Healthcare Provider Details

I. General information

NPI: 1992192074
Provider Name (Legal Business Name): CREATIVE SOLUTIONS IN HOME HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/16/2015
Last Update Date: 04/16/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

447 BELLA VIDA BLVD
ORLANDO FL
32828-6717
US

IV. Provider business mailing address

PO BOX 781577
ORLANDO FL
32878-1577
US

V. Phone/Fax

Practice location:
  • Phone: 407-252-4651
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License Number
License Number State

VIII. Authorized Official

Name: NIKA PALCESKI
Title or Position: OWNER
Credential:
Phone: 407-252-4651