Organization
CREATIVE CHILD CARE, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DEBRA EISON (EXECUTIVE DIRECTOR)
(209) 941-9100
Entity
Organization
Contact information
Practice address
4719 QUAIL LAKES DR, G-237, STOCKTON, CA 95207-5267
(209) 941-9100
(209) 941-9110
Mailing address
600 E MAIN ST, STOCKTON, CA 95202-3029
(209) 941-9100
(209) 941-9110
Taxonomy
Speciality
Code
Description
License number
State
251300000X
Local Education Agency (LEA)
Primary
—
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
39155742
—
CA
Enumeration date
11/07/2016
Last updated
11/07/2016
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