CREATUS ADULT ASSISTED LIVING, LLC (NPI# 1710502224) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1710502224 |
| Entity Type | Organization |
| Organization Name | CREATUS ADULT ASSISTED LIVING, LLC |
| Practice Address |
13414 Marburg Ln Upper Marlboro MD 20772-4809 |
| Practice Telephone | 3017419167 |
| Practice Fax Number | 3012030820 |
| Mailing Telephone | 3017419167 |
| Mailing Fax Number | 3012030820 |
| Enumeration Date | 2020-06-10 |
| Last Update Date | 2020-06-11 |
| Authorized Official Name | TERRY D QUATTLEBAUM (MANAGER PARTNER) |
| Authorized Official Telephone | 3017419167 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 310400000X | Assisted Living Facility | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MD | Q&A SOLUTIONS, LLC | 805338519 | 01 |
| Other Name | Type Code |
|---|---|
| Q&ABC Creatus Adult Assisted Living, LLC | Doing Business As Name - Organization |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | CREATUS ADULT ASSISTED LIVING, LLC | 13414 Marburg Ln, Upper Marlboro, MD 20772-4809 |
| Street Address |
13414 MARBURG LN |
| City | UPPER MARLBORO |
| State | MD |
| Zip Code | 20772-4809 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497355077 | Doris Lynn Perkins | Pharmacist | 5700 Southeast Crain Hwy, Upper Marlboro, MD 20772 | 2020-10-31 |
| 1730790221 | Creative Mind Therapy | Community/Behavioral Health | 12419 Dorsey Ln, Upper Marlboro, MD 20772 | 2020-08-10 |
| 1932727369 | Shaquitta Morton | Behavior Technician | 9440 Marlboro Pike 100, Upper Marlboro, MD 20772 | 2020-07-13 |
| 1760022958 | Keri Daniel | Nurse Practitioner | 9723 Frank Tippett Rd, Upper Marlboro, MD 20772 | 2020-01-15 |
| 1932668134 | Dentistry for Children of Maryland, LLC | Clinic/Center | 9616 Marlboro Pike, Upper Marlboro, MD 20772 | 2019-03-18 |
| 1033673918 | Shonte Renee Drakeford | Nurse Practitioner | 6610 Woodyard Road, Upper Marlboro, MD 20772 | 2019-01-25 |
| 1902391261 | Myenne Hanson | Home Health Aide | 5002 Ashford Dr, Upper Marlboro, MD 20772 | 2018-06-28 |
| 1659884849 | Clement Okehie | Home Health Aide | 13939 Bishops Bequest Rd, Upper Marlboro, MD 20772 | 2017-11-09 |
| 1497264766 | Fatu Barrie | Technician | 11112 Cranfod Drive, Upper Marlboro, MD 20772 | 2017-09-29 |
| 1801315080 | Hope Academy & Nursing Services | Nursing Care | 14101 Christian Street, Upper Marlboro, MD 20772 | 2017-09-19 |
| Find all providers in zip 20772 | ||||
| Taxonomy Code | 310400000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Assisted Living Facility |
| A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760718951 | Refreshing Springs Assisted Living Homes, Inc | Assisted Living Facility | 14519 Turner Wootton Pkwy, Upper Marlboro, MD 20774-8693 | 2009-10-23 |
| 1639327463 | Castles of Love Assisted Living Homes, LLC | Assisted Living Facility | 14711 Mount Calvert Rd, Upper Marlboro, MD 20772-9606 | 2008-09-05 |
| 1013116086 | Tasha Latrice Young | Assisted Living Facility | 4304 Arabella Ct, Upper Marlboro, MD 20772-9343 | 2007-07-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700486032 | Comfort At Home Care, LLC | Assisted Living Facility | 4628 Marble Hall Rd, Baltimore, MD 21239-3937 | 2020-10-27 |
| 1073113338 | Casa Living Inc | Assisted Living Facility | 13809 Doctor Edelen Dr, Accokeek, MD 20607-3786 | 2020-10-27 |
| 1528667011 | Affluent Living Adult Care | Assisted Living Facility | 4106 Maine Ave, Gwynn Oak, MD 21207-7503 | 2020-10-26 |
| 1134728678 | First-class Caregivers, LLC | Assisted Living Facility | 7214 Willow Hill Dr, Capitol Heights, MD 20743-2671 | 2020-10-24 |
| 1356940761 | Angel Living, LLC | Assisted Living Facility | 3978 Old Washington Rd, Waldorf, MD 20602-3217 | 2020-10-19 |
| 1740896182 | M&o Prestige Partnership LLC | Assisted Living Facility | 1805 Ashburton St, Baltimore, MD 21216-3538 | 2020-09-21 |
| 1497360986 | Merle Newkirk | Assisted Living Facility | 7606 Fox Hunt Ct, Clinton, MD 20735-3063 | 2020-09-10 |
| 1881209690 | Serenity Gardens Assisted Living LLC | Assisted Living Facility | 10829 Burbank Dr, Potomac, MD 20854-1557 | 2020-09-09 |
| 1700491560 | Evergreen Gardens Assisted Living | Assisted Living Facility | 10120 Stansfield Rd, Laurel, MD 20723-1738 | 2020-09-09 |
| 1124632211 | Citadel Management Group Inc. | Assisted Living Facility | 5360 Woodgate Ln, Waldorf, MD 20601-4457 | 2020-09-04 |
| Find all providers with the same taxonomy | ||||
| City | UPPER MARLBORO |
| Zip Code | 20772 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.