Provider Demographics
NPI:1881561025
Name:CREER SUPPORTIVE LIVING SERVICES, INC.
Entity type:Organization
Organization Name:CREER SUPPORTIVE LIVING SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KEDRA
Authorized Official - Middle Name:
Authorized Official - Last Name:CREER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:323-395-8594
Mailing Address - Street 1:13306 CHOCO RD
Mailing Address - Street 2:
Mailing Address - City:APPLE VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92308-4533
Mailing Address - Country:US
Mailing Address - Phone:323-395-8594
Mailing Address - Fax:323-395-8594
Practice Address - Street 1:13306 CHOCO RD
Practice Address - Street 2:
Practice Address - City:APPLE VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92308-4533
Practice Address - Country:US
Practice Address - Phone:323-395-8594
Practice Address - Fax:323-395-8594
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-10-22
Last Update Date:2025-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care