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General NPI Number Information
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NPI Number | 1891503801
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Entity Type | Organization
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Legal Business Name | CREATING INDEPENDENCE OT AND NURSING LLC
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Dates
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Enumeration Date | 12/23/2024
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Last Update Date | 12/23/2024
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Provider Practice Location Address
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Address Line | 65 DODGE ST UNIT C
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City | BEVERLY
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State | MA
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Zip | 01915-1700
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Country | US
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Telephone | 978-406-9664
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Fax |
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Provider Business Mailing Address
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Address Line | 82 BLUEBERRY LN
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City | SOUTH HAMILTON
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State | MA
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Zip | 01982-1204
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Country | US
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Telephone | 781-879-0917
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MRS. NICOLE ANN BROWN
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Credential | FNP-C, OTR/L
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Telephone | 781-879-0917
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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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Taxonomy #2
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Taxonomy Code | 251J00000X
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Taxonomy Name | Nursing Care Agency
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License Number |
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License Number State |
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