Organization
A LIFE OF CREATIVITY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KATIA BAKER (CEO/OWNER)
(941) 565-9803
Entity
Organization
Contact information
Practice address
10447 FLY FISHING ST, RIVERVIEW, FL 33569-2735
(941) 565-9803
Mailing address
10447 FLY FISHING ST, RIVERVIEW, FL 33569-2735
(941) 565-9803
Taxonomy
Speciality
Code
Description
License number
State
261QD1600X
Developmental Disabilities Clinic/Center
Primary
—
—
Other
Enumeration date
10/17/2022
Last updated
10/17/2022
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