Provider Demographics
NPI:1386338051
Name:CREATIVE CASE MANAGEMENT SERVICES LLC
Entity type:Organization
Organization Name:CREATIVE CASE MANAGEMENT SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LATONIA
Authorized Official - Middle Name:
Authorized Official - Last Name:WELLS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:678-668-0222
Mailing Address - Street 1:280 BECKENHAM WALK DR
Mailing Address - Street 2:
Mailing Address - City:DACULA
Mailing Address - State:GA
Mailing Address - Zip Code:30019-6898
Mailing Address - Country:US
Mailing Address - Phone:786-680-2226
Mailing Address - Fax:678-535-2963
Practice Address - Street 1:280 BECKENHAM WALK DR
Practice Address - Street 2:
Practice Address - City:DACULA
Practice Address - State:GA
Practice Address - Zip Code:30019-6898
Practice Address - Country:US
Practice Address - Phone:786-680-2226
Practice Address - Fax:678-535-2963
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-06
Last Update Date:2023-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management