Healthcare Provider Details

I. General information

NPI: 1528036969
Provider Name (Legal Business Name): CREATIVE FAMILY SOLUTIONS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/10/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

180 TEEL ST
CHRISTIANSBURG VA
24073-2564
US

IV. Provider business mailing address

180 TEEL ST
CHRISTIANSBURG VA
24073-2564
US

V. Phone/Fax

Practice location:
  • Phone: 540-381-3940
  • Fax: 540-381-3988
Mailing address:
  • Phone: 540-381-3940
  • Fax: 540-381-3988

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number StateVA

VIII. Authorized Official

Name: MRS. NANCY T STAFFORD
Title or Position: PRESIDENT/OWNER
Credential:
Phone: 540-381-3940