Provider Demographics
NPI:1043049208
Name:CREATORS MIND CARES4US
Entity type:Organization
Organization Name:CREATORS MIND CARES4US
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER
Authorized Official - Prefix:
Authorized Official - First Name:OMOIKE
Authorized Official - Middle Name:ERIC
Authorized Official - Last Name:AIZENOFE
Authorized Official - Suffix:
Authorized Official - Credentials:MDIV, BCC
Authorized Official - Phone:325-232-4205
Mailing Address - Street 1:PO BOX 530513
Mailing Address - Street 2:
Mailing Address - City:GRAND PRAIRIE
Mailing Address - State:TX
Mailing Address - Zip Code:75053-0513
Mailing Address - Country:US
Mailing Address - Phone:325-232-4205
Mailing Address - Fax:
Practice Address - Street 1:1074 S ERIE ST
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76112-7038
Practice Address - Country:US
Practice Address - Phone:325-232-4205
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-27
Last Update Date:2024-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based