Organization
CREUT HEALTHCARE, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANGELA CHINENYE OKIYIE REGISTERED NURSE (ADMISTRATOR)
(678) 591-4901
Entity
Organization
Contact information
Practice address
6982 MISTTOP LOOP, FAIRBURN, GA 30213-3060
(678) 591-4901
Mailing address
6982 MISTTOP LOOP, FAIRBURN, GA 30213-3060
(678) 591-4901
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
060-R-1067
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003141520A
—
GA
Enumeration date
08/29/2014
Last updated
08/29/2014
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