Organization
CREATING INDEPENDENCE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LETTY RUTH SHERRY (OFFICE MANAGER)
(269) 650-1373
Entity
Organization
Contact information
Practice address
416 E SUPERIOR ST, WAYLAND, MI 49348-1146
(269) 838-4660
Mailing address
416 E SUPERIOR ST, WAYLAND, MI 49348-1146
(269) 838-4660
Taxonomy
Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
Primary
621610
MI
Other
Enumeration date
03/09/2010
Last updated
03/09/2010
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