Healthcare Provider Details

I. General information

NPI: 1679887004
Provider Name (Legal Business Name): CREEKVIEW ADULT HEALTH AND ACTIVITY CENTER INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/27/2010
Last Update Date: 02/12/2020
Certification Date: 02/12/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7322 SOUTHWEST FWY STE 630J
HOUSTON TX
77074-2185
US

IV. Provider business mailing address

7322 SOUTHWEST FWY STE 630J
HOUSTON TX
77074-2185
US

V. Phone/Fax

Practice location:
  • Phone: 469-693-9380
  • Fax: 832-915-2837
Mailing address:
  • Phone: 469-693-9380
  • Fax: 832-915-2837

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State

VIII. Authorized Official

Name: VICTORIA OBASUYI
Title or Position: ADMINISTRATOR
Credential:
Phone: 972-271-8000