Creekside Place, Inc.

Primary specialty

Adult Care Home FacilityTaxonomy code 311ZA0620X

Legal business name

CREEKSIDE PLACE, INC.

Practice address

7251 N Briarcliff Knoll Dr
West Bloomfield, MI 48322-4049

Phone

(877) 327-5484

Fax

(248) 250-5999

NPI assigned

Jul 8, 2020

Last updated

Jul 8, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Puja Borso, OTR/L, CLT, CAPSNPI 1588955322

Title

Administrator

Phone

(248) 346-4515

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Puja Borso, OTR

  • Occupational Therapist
  • Clarkston, MI
  • NPI 1588955322
  NPD (past) Authorized official

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

{
    "created_epoch": "1594166400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1594166400000",
    "number": "1194343046",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2995 WEIDEMANN DR",
            "city": "CLARKSTON",
            "state": "MI",
            "postal_code": "483481249",
            "telephone_number": "248-346-4515",
            "fax_number": "248-250-5999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7251 N BRIARCLIFF KNOLL DR",
            "city": "WEST BLOOMFIELD",
            "state": "MI",
            "postal_code": "483224049",
            "telephone_number": "877-327-5484",
            "fax_number": "248-250-5999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CREEKSIDE PLACE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-07-08",
        "last_updated": "2020-07-08",
        "certification_date": "2020-07-08",
        "status": "A",
        "authorized_official_last_name": "BORSO",
        "authorized_official_first_name": "PUJA",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "248-346-4515",
        "authorized_official_credential": "OTR/L, CLT, CAPS"
    },
    "taxonomies": [
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE NUMBER",
            "identifier": "AS630397523",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Karl Cox
• Claudia Coxx, LMSW
• Rachel Erin Crane, MSW
• Breanne Craven Gordon, PA-C
• Crawford Infinite
• Anne Crook, LMSW, CCM
• Toria Rae Crumback
• Joanne Pegina Cruz, MSN, NP-C
• Kristina Cullen, AGACNP
• Pamela Ann Curran, PT

• Adult Care Home Facility in West Bloomfield, MI
• Providers in West Bloomfield, MI by specialty
• Adult Care Home Facility in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2020; 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.