Creekside Corporation Inc

Primary specialty

In Home Supportive Care AgencyTaxonomy code 253Z00000X

Legal business name

CREEKSIDE CORPORATION INC

Practice address

9332 Annapolis Rd Ste 216
Lanham, MD 20706-3142

Phone

(240) 472-5758

NPI assigned

Nov 7, 2023

Organization subpart

No

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

Authorized official

Name

Yetunde Fatoki

Title

Administrator

Phone

(240) 472-5758

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1699315200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1699315200000",
    "number": "1235903550",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9332 ANNAPOLIS RD STE 216",
            "city": "LANHAM",
            "state": "MD",
            "postal_code": "207063142",
            "telephone_number": "240-472-5758"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9332 ANNAPOLIS RD STE 216",
            "city": "LANHAM",
            "state": "MD",
            "postal_code": "207063142",
            "telephone_number": "240-472-5758"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CREEKSIDE CORPORATION INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-11-07",
        "last_updated": "2023-11-07",
        "certification_date": "2023-11-07",
        "status": "A",
        "authorized_official_last_name": "FATOKI",
        "authorized_official_first_name": "YETUNDE",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "240-472-5758"
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2023; 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.