Organization
CREATOR ORIGINAL SERVICES INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AUDREY R RICHARDS (PRESIDENT)
(321) 299-6563
Entity
Organization
Contact information
Practice address
6828 POMEROY CIR, ORLANDO, FL 32810-6575
(321) 299-6563
(407) 641-8693
Mailing address
6828 POMEROY CIR, ORLANDO, FL 32810-6575
(321) 299-6563
(407) 641-8693
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
230911
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
230911
AGENCY FOR HEALTH CARE ADMINISTRATION
FL
Enumeration date
04/21/2015
Last updated
04/21/2015
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