Organization
CREATIVE IMAGE PERSONAL CARE SERVICE LLC
Active
Other names
CREATIVE IMAGE RESPITE CARE SERVICE LLC
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CHANDRA RENA THOMAS (CEO/OWNER)
(662) 379-0238
Entity
Organization
Contact information
Practice address
503 HIGHWAY 82 E, INDIANOLA, MS 38751-2317
(662) 379-0238
(662) 887-8050
Mailing address
216 FRENCH RD, INDIANOLA, MS 38751-9668
(662) 379-0238
(662) 887-8050
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
311ZA0620X-ADULTCARE
—
385H00000X
Respite Care
Primary
385H00000X-RESPITE
MS
Other
Enumeration date
11/09/2016
Last updated
11/09/2016
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