CREATIVE COMMUNITY LIVING SERVICES, INC. (NPI# 1265625834) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1265625834 |
| Entity Type | Organization |
| Organization Name | CREATIVE COMMUNITY LIVING SERVICES, INC. |
| Practice Address |
314 E Main St Watertown WI 53094-3749 |
| Mailing Address |
314 E Main St P.o. Box 260 Watertown WI 53094-3749 |
| Practice Telephone | 9202611345 |
| Mailing Telephone | 9202611345 |
| Enumeration Date | 2007-08-27 |
| Last Update Date | 2007-08-27 |
| Authorized Official Name | MRS. LUANNE M. BARNET (PRESIDENT) |
| Authorized Official Telephone | 9202611345 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251C00000X | Day Training, Developmentally Disabled Services | Agencies |
| Street Address |
314 E MAIN ST |
| City | WATERTOWN |
| State | WI |
| Zip Code | 53094-3749 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861025371 | Addie Marie Littrell | Pharmacist | 624 S Church Street, Pharmacy Department, Watertown, WI 53094 | 2020-02-13 |
| 1144788274 | Robert Scott Johnson | Dentist | 314 W. Main St., Watertown, WI 53094 | 2019-03-07 |
| 1043785264 | Christian Long | Physical Therapist | Watertown Regional Medical Center, 1684 S Church St, Watertown, WI 53094 | 2018-10-04 |
| 1558566497 | Georgia E Meyer | Occupational Therapist | Rahab In Motion, 615 East Main St Suite B, Watertown, WI 53094 | 2007-06-20 |
| 1588789036 | Kjm Enterprises Inc | Home Health | 111 N Third Street, Watertown, WI 53094 | 2007-03-20 |
| 1114085412 | Paul R Sommers Dds Sc | Dentist | 121 Oakridge Court, Watertown, WI 53094 | 2006-12-05 |
| 1063593614 | Stein Optical Inc | Eyewear Supplier (Equipment, not the service) | 622 S Church St, Watertown, WI 53094 | 2006-10-18 |
| 1598851800 | David J Groh | Dentist | 1521 Doctors Ct, Watertown, WI 53094 | 2006-10-05 |
| 1861594251 | Robert Delano Heinen | General Practice | 700 Hoffmann Dr, Bethesda Lutheran Homes and Services, Watertown, WI 53094 | 2006-09-05 |
| 1669483897 | Donald Alan Wollheim | Surgery | 1911 Gateway Drive, Watertown, WI 53094 | 2006-08-11 |
| Find all providers in zip 53094 | ||||
| Taxonomy Code | 251C00000X |
| Grouping | Agencies |
| Classification | Day Training, Developmentally Disabled Services |
| These agencies are authorized to provide day habilitation services to developmentally disabled individuals who live in their homes. The function of day habilitation is to assist an individual to acquire and maintain those life skills that enable the individual to cope more effectively with the demands of independent living. Also to raise the level of the individual's physical, mental, social, and vocational functioning. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013543867 | Empower: Inclusive Employment and Education Consultants | Day Training, Developmentally Disabled Services | 108 Angel Ave Nw, Watertown, MN 55388-8255 | 2020-03-12 |
| 1780886853 | United Cerebral Palsy Association of Metro Boston | Day Training, Developmentally Disabled Services | 71 Arsenal St., Watertown, MA 02472-2638 | 2007-06-01 |
| 1639370067 | United Cerebal Palsy Association of Metro Boston | Day Training, Developmentally Disabled Services | 71 Arsenal St, Watertown, MA 02472-2638 | 2007-05-31 |
| 1831224039 | United Cerebral Palsy Association of Metro Boston | Day Training, Developmentally Disabled Services | 71 Arsenal Street, Watertown, MA 02472 | 2007-02-21 |
| 1205387727 | Beaverbrook Step, Inc. | Day Training, Developmentally Disabled Services | 85 Main St, 2nd Floor, Watertown, MA 02472-4411 | 2016-10-19 |
| 1275652026 | Project Interact, Inc | Day Training, Developmentally Disabled Services | 27 Siemon Company Dr, Suite 312, Watertown, CT 06795-2654 | 2007-03-29 |
| 1366579617 | Toward Independent Living & Learning, Inc. | Day Training, Developmentally Disabled Services | 610 Pleasant St, Watertown, MA 02472-2422 | 2007-02-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346863180 | Vitality Youth Services, LLC | Day Training, Developmentally Disabled Services | 726 12th Ave, Monroe, WI 53566-1435 | 2020-05-27 |
| 1568096394 | Lisa Roberta Meyer | Day Training, Developmentally Disabled Services | 325 S. Military Rd., Stockbridge, WI 53088 | 2020-03-02 |
| 1912545633 | Brotherly Love, LLC | Day Training, Developmentally Disabled Services | 1513 E Frances St, Appleton, WI 54911 | 2019-12-12 |
| 1144797739 | Able Residential & Community Options, LLC | Day Training, Developmentally Disabled Services | 909 S 29th St, Manitowoc, WI 54220-4461 | 2018-11-01 |
| 1902386055 | Islands of Brilliance | Day Training, Developmentally Disabled Services | 415 E Menomonee St, Milwaukee, WI 53202-6117 | 2018-08-17 |
| 1790275378 | United Communities Adult Daycare Service Inc | Day Training, Developmentally Disabled Services | 5330 W Lisbon Ave, Milwaukee, WI 53210-2751 | 2018-05-18 |
| 1649778861 | Easter Seals Southeast Wisconsin | Day Training, Developmentally Disabled Services | 7101 53rd St, Kenosha, WI 53144-7848 | 2018-01-23 |
| 1912448283 | Easter Seals Southeast Wisconsin | Day Training, Developmentally Disabled Services | 1120 Baxter St, Waukesha, WI 53186-3884 | 2017-03-20 |
| 1053852079 | Easter Seals Southeast Wisconsin | Day Training, Developmentally Disabled Services | 201 Wisconsin Ave, Waukesha, WI 53186-4926 | 2017-03-09 |
| 1437694338 | Bekus Adult Day Program LLC | Day Training, Developmentally Disabled Services | 4425 N 63rd St, Milwaukee, WI 53218-5548 | 2016-12-31 |
| Find all providers with the same taxonomy | ||||
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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.