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General NPI Number Information
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NPI Number | 1114388626
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Entity Type | Organization
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Legal Business Name | OAKWOOD CREATIVE CARE INC.
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Dates
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Enumeration Date | 03/10/2016
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Last Update Date | 04/08/2024
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Provider Practice Location Address
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Address Line | 247 N MACDONALD 102
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City | MESA
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State | AZ
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Zip | 85201-6622
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Country | US
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Telephone | 480-464-1061
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Fax | 480-464-1166
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Provider Business Mailing Address
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Address Line | 6915 E MAIN ST
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City | MESA
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State | AZ
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Zip | 85207-8229
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Country | US
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Telephone | 480-464-1061
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Fax | 480-464-1166
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Authorized Official
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Title or Position | PRESIDENT AND CEO
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Name | SHERRI FRIEND
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Credential |
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Telephone | 480-464-1061
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QA0600X
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Taxonomy Name | Adult Day Care Clinic/Center
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License Number | AL0164D
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License Number State | AZ
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