Healthcare Provider Details

I. General information

NPI: 1679482236
Provider Name (Legal Business Name): CREATIVE CARE TRAINING AND SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/01/2026
Last Update Date: 09/01/2026
Certification Date: 09/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3613 READING RD APT 203
CINCINNATI OH
45229-2342
US

IV. Provider business mailing address

3613 READING RD APT 203
CINCINNATI OH
45229-2342
US

V. Phone/Fax

Practice location:
  • Phone: 513-368-8116
  • Fax:
Mailing address:
  • Phone: 513-368-8116
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251300000X
TaxonomyLocal Education Agency (LEA)
License Number
License Number State

VIII. Authorized Official

Name: TRACEY D LAINE
Title or Position: OWNER
Credential:
Phone: 513-368-8116