NPIMap

Organization Active NPI

Creative Healthcare Services Corporation

  • Child Intellectual and/or Developmental Disabilities Respite Care
  • Turnersville, NJ
National Provider Identifier
1073022455
Registry record updated Sep 28, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Child Intellectual and/or Developmental Disabilities Respite CareTaxonomy code 385HR2060X
Legal business name
CREATIVE HEALTHCARE SERVICES CORPORATION
Practice address
600 Route 168
Turnersville, NJ 08012-1495
Phone
(856) 979-9690
NPI assigned
Sep 28, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2017

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Eugene Oledimma
Title
President
Phone
(856) 979-9690

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Child Intellectual and/or Developmental Disabilities Respite Care 385HR2060X Primary

Addresses

Primary practice location

600 Route 168
Turnersville, NJ 08012-1495

Mailing address

320 Copperfield Dr
Williamstown, NJ 08094-9260
Phone (856) 979-9690

Other identifiers 1

IdentifierTypeStateIssuer
0502499MedicaidNJ

National Provider Directory

National Provider Directory
Tax ID family
Creative Healthcare Services Corporation4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1506556800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1506556800000",
    "number": "1073022455",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "320 COPPERFIELD DR",
            "city": "WILLIAMSTOWN",
            "state": "NJ",
            "postal_code": "080949260",
            "telephone_number": "856-979-9690"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 ROUTE 168",
            "city": "TURNERSVILLE",
            "state": "NJ",
            "postal_code": "080121495",
            "telephone_number": "856-979-9690"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CREATIVE HEALTHCARE SERVICES CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-09-28",
        "last_updated": "2017-09-28",
        "status": "A",
        "authorized_official_last_name": "OLEDIMMA",
        "authorized_official_first_name": "EUGENE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "856-979-9690"
    },
    "taxonomies": [
        {
            "code": "385HR2060X",
            "taxonomy_group": "",
            "desc": "Respite Care, Respite Care, Intellectual and/or Developmental Disabilities, Child",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0502499",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Turnersville, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.