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General NPI Number Information
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NPI Number | 1477365310
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Entity Type | Organization
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Legal Business Name | CREATIVE ADVENTURE THERAPY SERVICES
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Dates
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Enumeration Date | 01/27/2025
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Last Update Date | 01/27/2025
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Provider Practice Location Address
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Address Line | 3900 NE 18TH AVE APT 1603
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City | POMPANO BEACH
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State | FL
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Zip | 33064-9212
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Country | US
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Telephone | 954-608-1957
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Fax |
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Provider Business Mailing Address
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Address Line | 3900 NE 18TH AVE APT 1603
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City | POMPANO BEACH
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State | FL
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Zip | 33064-9212
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Country | US
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Telephone | 954-608-1957
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | ELIZABETH PELLER
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Credential | OTR/L
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Telephone | 954-608-1957
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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