Provider Demographics
NPI:1902259229
Name:CREATIVE MILESTONES SUPPORT SERVICES INC
Entity Type:Organization
Organization Name:CREATIVE MILESTONES SUPPORT SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:TARMEKA
Authorized Official - Middle Name:
Authorized Official - Last Name:PRESTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:321-439-6837
Mailing Address - Street 1:3407 HARRY ST
Mailing Address - Street 2:
Mailing Address - City:APOPKA
Mailing Address - State:FL
Mailing Address - Zip Code:32712-5856
Mailing Address - Country:US
Mailing Address - Phone:321-439-6837
Mailing Address - Fax:
Practice Address - Street 1:3407 HARRY ST
Practice Address - Street 2:
Practice Address - City:APOPKA
Practice Address - State:FL
Practice Address - Zip Code:32712-5856
Practice Address - Country:US
Practice Address - Phone:321-439-6837
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-21
Last Update Date:2022-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251B00000XAgenciesCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL104154400Medicaid
FL106444700Medicaid