Organization
CREATIVE HOME CARE PROVIDERS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JULIUS DALLO (PRESIDENT)
(586) 665-5566
Entity
Organization
Contact information
Practice address
49136 VAN DYKE AVE, SHELBY TOWNSHIP, MI 48317-1332
(248) 606-4991
Mailing address
49136 VAN DYKE AVE, SHELBY TOWNSHIP, MI 48317-1332
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
—
—
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9547017
—
MI
Enumeration date
09/14/2021
Last updated
09/14/2021
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