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General NPI Number Information
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NPI Number | 1376713834
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Entity Type | Organization
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Legal Business Name | CREATIVE OPTIONS, INC.
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Dates
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Enumeration Date | 03/11/2008
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Last Update Date | 03/11/2008
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Provider Practice Location Address
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Address Line | 91 WEAVER RD
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City | NORTH KINGSTOWN
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State | RI
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Zip | 02852-7135
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Country | US
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Telephone | 401-742-2839
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Fax |
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Provider Business Mailing Address
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Address Line | 91 WEAVER RD
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City | NORTH KINGSTOWN
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State | RI
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Zip | 02852-7135
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Country | US
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Telephone | 401-742-2839
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | MR. EDMUND J. SULLIVAN
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Credential |
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Telephone | 401-742-2957
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251C00000X
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Taxonomy Name | Developmentally Disabled Services Day Training Agency
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License Number |
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License Number State |
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