MEDICARE: CREATIVE ALTERNATIVES 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	322D00000X	Emotionally Disturbed Childrens' Residential Treatment Facility	500311481	CA

General Provider Information

NPI Number	:	1730625898
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CREATIVE ALTERNATIVES INC.

Provider Business Mailing Address
First Line	:	2855 GEER RD
Second Line	:
City	:	TURLOCK
State	:	CA
Zip	:	95382-1133
Country	:	US
Telephone Number	:	209-668-9361
Fax Number	:	209-668-0539

Provider Business Practice Location Address
First Line	:	1195 E TUOLUMNE RD
Second Line	:
City	:	TURLOCK
State	:	CA
Zip	:	95382-1541
Country	:	US
Telephone Number	:	209-632-9600
Fax Number	:

Authorized Official
Title or Position	:	ASSISTANT EXECUTIVE DIRECTOR
Name	:	LISA JACOBS
Credential	:	MPA
Telephone Number	:	209-668-9361

Provider Enumeration Date	:	01/13/2017
Last Update Date	:	09/24/2025

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