Organization
CREATIVE SPARK THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CRYSTAL LOZANO (PRESIDENT)
(786) 417-8272
Entity
Organization
Contact information
Practice address
2110 NE 38TH RD, HOMESTEAD, FL 33033-5104
(786) 417-8272
Mailing address
2110 NE 38TH RD, HOMESTEAD, FL 33033-5104
(786) 417-8272
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
02/09/2019
Last updated
02/09/2019
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