MEDICARE: CREATIVE BLESSINGS HOME HEALTHCARE AGENCY INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251J00000X	Nursing Care Agency

General Provider Information

NPI Number	:	1245381656
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CREATIVE BLESSINGS HOME HEALTHCARE AGENCY INC

Provider Business Mailing Address
First Line	:	PO BOX 48416
Second Line	:
City	:	CUMBERLAND
State	:	NC
Zip	:	28331-8416
Country	:	US
Telephone Number	:	910-527-6384
Fax Number	:	910-221-9871

Provider Business Practice Location Address
First Line	:	2018 FORT BRAGG RD
Second Line	:	SUITE 114-B
City	:	FAYETTEVILLE
State	:	NC
Zip	:	28303-7037
Country	:	US
Telephone Number	:	910-221-4467
Fax Number	:	910-221-9871

Authorized Official
Title or Position	:	DIRECTOR
Name	:	MRS. AMANDA DINETH ROGERS
Credential	:
Telephone Number	:	910-527-6384

Provider Enumeration Date	:	01/13/2007
Last Update Date	:	08/22/2020

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