Organization
CREATIVE VILLAGE CONNECTIONS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LATESHIA ROBERTS (PART OWNER)
(612) 804-9624
Entity
Organization
Contact information
Practice address
6825 ZENITH AVE N, BROOKLYN CENTER, MN 55429-4210
(612) 804-9624
Mailing address
6825 ZENITH AVE N, BROOKLYN CENTER, MN 55429-4210
(612) 804-9624
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
—
251E00000X
Home Health Agency
Primary
—
—
343900000X
Non-emergency Medical Transport (VAN)
—
—
Other
Enumeration date
06/26/2024
Last updated
06/26/2024
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