Organization
CREATIVE INDEPENDENT ALLIANCE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. PAMELAN PENDLETON (EXECUTIVE DIRECTOR)
(267) 275-2393
Entity
Organization
Contact information
Practice address
1 INTERNATIONAL PLZ, SUITE 550, PHILADELPHIA, PA 19113-1510
(267) 275-2393
Mailing address
1 INTERNATIONAL PLZ, SUITE 550, PHILADELPHIA, PA 19113-1510
(267) 275-2393
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
—
251S00000X
Community/Behavioral Health Agency
Primary
6417465
PA
252Y00000X
Early Intervention Provider Agency
—
—
Other
Enumeration date
06/27/2016
Last updated
07/11/2016
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