NPI 1124431788

Creations-Unlimited

Organisation Early Intervention Provider Agency Lake City, SC

Practice location

Address: 318 Moore St, Lake City, SC 29560-2551
Phone: (804) 519-8009
Fax: (804) 525-5444
Mailing address: 6453 Goldenrod CT, Henrico, VA 23231-5330

Authorised official

Name: Jerry Rose
Title: Owner/Ceo
Phone: (804) 519-8009

Registered specialties

Early Intervention Provider Agency Primary

Agencies Taxonomy 252Y00000X

Other Early Intervention Provider Agency providers in South Carolina →

Registry record

NPI: 1124431788
Entity type: Organization
NPI issued: 10 Jun 2014
Record last updated: 10 Jun 2014

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.