# CREATIONS-UNLIMITED

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1124431788
- **Authorized official:** MR. JERRY ROSE (OWNER/CEO)
- **Authorized official phone:** (804) 519-8009

## Contact information

- **Practice address:** 318 MOORE ST, LAKE CITY, SC 29560-2551
- **Practice address phone:** (804) 519-8009
- **Practice address fax:** (804) 525-5444
- **Mailing address:** 6453 GOLDENROD CT, HENRICO, VA 23231-5330
- **Mailing address phone:** (804) 519-8009
- **Mailing address fax:** (804) 525-5444

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 252Y00000X | Early Intervention Provider Agency | — | NULL | Yes |

## Other

- **Enumeration date:** 06/10/2014
- **Last updated:** 06/10/2014