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General NPI Number Information
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NPI Number | 1962900761
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Entity Type | Organization
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Legal Business Name | CREATIVE HEALTHCARE SERVICES CORPORATION
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Dates
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Enumeration Date | 01/26/2018
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Last Update Date | 01/26/2018
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Provider Practice Location Address
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Address Line | 600 ROUTE 168
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City | TURNERSVILLE
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State | NJ
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Zip | 08012-1495
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Country | US
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Telephone | 856-979-9690
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Fax |
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Provider Business Mailing Address
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Address Line | 320 COPPERFIELD DR
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City | WILLIAMSTOWN
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State | NJ
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Zip | 08094-9260
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Country | US
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Telephone | 856-979-9690
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | EUGENE OLEDIMMA
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Credential |
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Telephone | 856-979-9690
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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