Organization
CO-CREATIVE HEALING, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CATHY S BRADWAY (PRESIDENT/OWNER)
(919) 274-1698
Entity
Organization
Contact information
Practice address
975 WALNUT ST STE 236, CARY, NC 27511-4216
(919) 274-1698
Mailing address
975 WALNUT ST STE 236, CARY, NC 27511-4216
(919) 274-1698
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
092864
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2809014
MEDICARE
NC
Enumeration date
08/31/2007
Last updated
08/31/2007
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