Organization
CREATIVELY CHANGING LIVES INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MITSCH BEAGUE (OWNER)
(727) 337-3526
Entity
Organization
Contact information
Practice address
5000 STATE ROAD 54, NEW PORT RICHEY, FL 34652-5908
(727) 337-3526
Mailing address
5314 LINDER PL, NEW PORT RICHEY, FL 34652-3734
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
—
—
Other
Enumeration date
01/17/2024
Last updated
01/17/2024
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