CREATIVE CHILD AND FAMILY SERVICES, INC. (NPI# 1720645328) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1720645328 |
Entity Type | Organization |
Organization Name | CREATIVE CHILD AND FAMILY SERVICES, INC. |
Practice Address |
7049 Ohio River Dr Eastvale CA 91752 |
Mailing Address |
1655 E. 6th Street A-4 #102 Corona CA 92879 |
Practice Telephone | 3109462398 |
Practice Fax Number | 9514795169 |
Mailing Telephone | 9095482959 |
Mailing Fax Number | 9514795169 |
Enumeration Date | 2019-05-20 |
Last Update Date | 2019-05-20 |
Authorized Official Name | BARBARA TIMMONS (CEO) |
Authorized Official Telephone | 3109462398 |
Is Organization Subpart | Y |
Parent Organization Name | CREATIVE CHILD AND FAMILY SERVICES, IN |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 207QA0401X |
Family Medicine Specialization: Addiction Medicine |
Allopathic & Osteopathic Physicians |
Entity Type | Entity Name | Entity Address |
---|---|---|
System for Award Management (SAM) Entities | CREATIVE CHILD AND FAMILY SERVICES, INC. | 11254 Poulsen Ave, Montclair, CA 91763-6533 |
Street Address |
7049 OHIO RIVER DR |
City | EASTVALE |
State | CA |
Zip Code | 91752 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1124673462 | National Vision Inc | Optometrist | 12585 Cantu Galleano Ranch Road, Suite 120, Eastvale, CA 91752 | 2019-08-05 |
1124681150 | Sleep Dme Management, Inc. | Home Health Aide | 12523 Limonite Avenie, #440-341, Mira Loma, CA 91752 | 2019-04-16 |
1255835179 | Costco Wholesale Corporation | Hearing Aid Equipment | 5030 Hamner Ave., Eastvale, CA 91752 | 2018-03-23 |
1487171963 | Devin Davis | Behavioral Analyst | 6632 Leanne St., Mira Loma, CA 91752 | 2017-08-25 |
1063946226 | Help Me Rhonda | Point of Service | 5919 Sunny Circle, Mira Loma, CA 91752 | 2017-04-14 |
1477930949 | Avinash Mirle Chandrashekar | Speech-Language Pathologist | 5725 Darbreak Dr, Apt C, Eastvale, CA 91752 | 2015-05-04 |
1336371061 | Prior Board & Care | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 6121 Jupiter Dr., Mira Loma, CA 91752 | 2009-08-13 |
1245497288 | Elizabeth E Williamson | Dentist | 12571 Limonite Avenue, Suite 230, Mira Loma, CA 91752 | 2008-05-19 |
1003099425 | Dhama and Rodgers Dental Corporation | Dentist | 6445 Pat's Ranch Road, Ste G, Mira Loma, CA 91752 | 2007-12-07 |
1144830571 | Huey Q Tran, Dds, Inc. | Dentist | 12363 Limonite Ave Ste 960, Eastvale, CA 91752 | 2020-07-31 |
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Taxonomy Code | 207QA0401X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Family Medicine |
Specialization | Addiction Medicine |
A family medicine physician who specializes in the diagnosis and treatment of addictions. |
Notes: Source: National Uniform Claim Committee, 2009 [1/1/2010: definition added, source added] Additional Resources: A Certification of Added Qualifications (CAQ) was, but is no longer issued by the American Osteopathic Board of Family Physicians. |
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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.