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General NPI Number Information
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NPI Number | 1992876031
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Entity Type | Organization
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Legal Business Name | CREATIVE HOME HEALTH CARE LLC
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Dates
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Enumeration Date | 11/12/2006
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Last Update Date | 08/30/2007
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Provider Practice Location Address
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Address Line | 311 TRINDALE RD
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City | ARCHDALE
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State | NC
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Zip | 27263-2751
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Country | US
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Telephone | 336-861-5263
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Fax | 336-861-5263
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Provider Business Mailing Address
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Address Line | PO BOX 4805
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City | ARCHDALE
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State | NC
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Zip | 27263-4805
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Country | US
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Telephone | 336-861-5263
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Fax | 336-861-5263
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Authorized Official
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Title or Position | OWNER PRESIDENT
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Name | MR. STEVEN DALE JONES
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Credential |
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Telephone | 336-861-5263
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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 | HC3477
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License Number State | NC
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