=====================================================
General NPI Number Information
=====================================================
NPI Number | 1619035391
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | CREATIVE EMPLOYMENT OPPORTUNITIES, INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/05/2006
-----------------------------------------------------
Last Update Date | 02/14/2013
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 34820 HARPER AVE
-----------------------------------------------------
City | CLINTON TWP
-----------------------------------------------------
State | MI
-----------------------------------------------------
Zip | 48035-3710
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 586-569-4250
-----------------------------------------------------
Fax | 586-569-4259
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 34820 HARPER AVE
-----------------------------------------------------
City | CLINTON TWP
-----------------------------------------------------
State | MI
-----------------------------------------------------
Zip | 48035-3710
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 586-569-4250
-----------------------------------------------------
Fax | 586-569-4259
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | EXECUTIVE DIRECTOR
-----------------------------------------------------
Name | MS. KATHLEEN MARIE KUNZ-PIELACK
-----------------------------------------------------
Credential | LSW
-----------------------------------------------------
Telephone | 586-569-4250
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251C00000X
-----------------------------------------------------
Taxonomy Name | Developmentally Disabled Services Day Training Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------