Organization
CREATIVE GROWTH GROUP INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT BEAGUE (PRES)
(813) 408-1520
Entity
Organization
Contact information
Practice address
12941 ROYAL GEORGE AVE, ODESSA, FL 33556-5710
(813) 408-1520
Mailing address
12941 ROYAL GEORGE AVE, ODESSA, FL 33556-5710
(813) 408-1520
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
—
—
Other
Enumeration date
02/08/2016
Last updated
02/08/2016
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