Organization
CREATIVE CARE SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
YER YANG (PROGRAM DIRECTOR)
(612) 545-5290
Entity
Organization
Contact information
Practice address
4167 LYNDALE AVE N STE 301, MINNEAPOLIS, MN 55412-1737
(612) 545-5290
Mailing address
4167 LYNDALE AVE N STE 301, MINNEAPOLIS, MN 55412-1737
(612) 545-5290
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
15709
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
15709
SOCIAL WORKER LIC
MN
Enumeration date
04/27/2015
Last updated
04/27/2015
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