| Organization Name: | CREATIVE HOME HOSPICE INC. |
| NPI Number: | 1124007927 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | REBECCA COFFMAN (PRESIDENT) |
| Mailing Address: | 2703 N Broadway St Poteau |
| State: | OK US |
| Postal Code: | 749535403 |
| Phone Number: | 9186478009 |
| Fax Number: | 9186477041 |
| NPI Enumeration Date: | 01/11/2006 |
| NPI Last Update Date: | 12/10/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 251G00000X |
| License Number: | 4143 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | OK |
| Taxonomy Type: | Agencies |
| Taxonomy Classification: | Hospice Care, Community Based |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |