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General NPI Number Information
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NPI Number | 1750521779
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Entity Type | Organization
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Legal Business Name | CREATIVE HEALTH SOLUTIONS LLC
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Dates
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Enumeration Date | 03/03/2009
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Last Update Date | 09/01/2016
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Provider Practice Location Address
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Address Line | 3900 JERMANTOWN RD STE 250
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City | FAIRFAX
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State | VA
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Zip | 22030-4946
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Country | US
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Telephone | 703-910-5006
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Fax | 888-314-6706
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Provider Business Mailing Address
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Address Line | 3900 JERMANTOWN RD STE 250
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City | FAIRFAX
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State | VA
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Zip | 22030-4946
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Country | US
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Telephone | 703-910-5006
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Fax | 888-314-6706
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Authorized Official
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Title or Position | CHIEF OPERATING OFFICER
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Name | RICHARD FEINGOLD
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Credential |
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Telephone | 703-910-5006
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number | 1003854381
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License Number State | VA
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