Healthcare Provider Details

I. General information

NPI: 1457296600
Provider Name (Legal Business Name): KREATIVE KARE HOME HEALTHCARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/22/2026
Last Update Date: 05/17/2026
Certification Date: 05/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5825 BISHOP DR
COLUMBUS GA
31909-5514
US

IV. Provider business mailing address

5825 BISHOP DR
COLUMBUS GA
31909-5514
US

V. Phone/Fax

Practice location:
  • Phone: 762-262-5048
  • Fax:
Mailing address:
  • Phone: 762-262-5048
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State

VIII. Authorized Official

Name: YENA MORRIS
Title or Position: OWNER
Credential:
Phone: 762-262-5048