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General NPI Number Information
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NPI Number | 1740881911
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Entity Type | Organization
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Legal Business Name | CREATIONS OF CARE HOME CARE LLC.
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Dates
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Enumeration Date | 11/04/2020
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Last Update Date | 09/23/2021
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Provider Practice Location Address
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Address Line | 2434 D-13 PASS ROAD
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City | BILOXI
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State | MS
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Zip | 39531
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Country | US
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Telephone | 228-641-7561
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Fax | 844-836-2419
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Provider Business Mailing Address
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Address Line | 2367 TRAFALGAR DR
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City | BILOXI
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State | MS
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Zip | 39531-2277
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Country | US
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Telephone | 228-641-7561
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Fax | 678-827-0831
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Authorized Official
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Title or Position | OWNER
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Name | RENEE GUSTA-GARRETT
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Credential |
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Telephone | 228-641-7561
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YS0200X
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Taxonomy Name | School Counselor
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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 | 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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