Provider Demographics
NPI:1215793997
Name:CREATIVE HOME HEALTH
Entity type:Organization
Organization Name:CREATIVE HOME HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:CHERRY
Authorized Official - Middle Name:
Authorized Official - Last Name:TWIGGS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-704-6918
Mailing Address - Street 1:PO BOX 5636
Mailing Address - Street 2:
Mailing Address - City:PLANT CITY
Mailing Address - State:FL
Mailing Address - Zip Code:33563-0047
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:415 N WILDER RD
Practice Address - Street 2:
Practice Address - City:PLANT CITY
Practice Address - State:FL
Practice Address - Zip Code:33566-7544
Practice Address - Country:US
Practice Address - Phone:813-704-6918
Practice Address - Fax:866-240-5666
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FLORRY CREATIVE CARE CORPORATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-02-21
Last Update Date:2024-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health