Healthcare Provider Details

I. General information

NPI: 1720317951
Provider Name (Legal Business Name): CREATIVE CARE PARTNERS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/17/2009
Last Update Date: 12/17/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

48603 CRESCENT DR
MACOMB MI
48044-2117
US

IV. Provider business mailing address

48603 CRESCENT DR
MACOMB MI
48044-2117
US

V. Phone/Fax

Practice location:
  • Phone: 586-231-0526
  • Fax: 586-231-0527
Mailing address:
  • Phone: 586-231-0526
  • Fax: 586-231-0527

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code372600000X
TaxonomyAdult Companion
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number State

VIII. Authorized Official

Name: MRS. KRISTA KULIGOWSKI
Title or Position: OWNER
Credential:
Phone: 586-321-0526