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General NPI Number Information
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NPI Number | 1619263365
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Entity Type | Organization
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Legal Business Name | CREATIVE ALTERNATIVES INC.
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Dates
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Enumeration Date | 06/21/2011
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Last Update Date | 08/09/2022
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Provider Practice Location Address
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Address Line | 2855 GEER RD
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City | TURLOCK
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State | CA
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Zip | 95382-1133
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Country | US
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Telephone | 209-668-9361
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Fax |
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Provider Business Mailing Address
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Address Line | 2855 GEER RD
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City | TURLOCK
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State | CA
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Zip | 95382-1133
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PROGRAM DIRECTOR
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Name | MS. LISA JACOBS
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Credential |
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Telephone | 209-668-9361
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 322D00000X
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Taxonomy Name | Emotionally Disturbed Childrens' Residential Treatment Facility
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License Number | 247200609
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License Number State | CA
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