Healthcare Provider Details

I. General information

NPI: 1497048953
Provider Name (Legal Business Name): CREATIVE OPTIONS FOR POSTIVE EDUCATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/17/2011
Last Update Date: 05/17/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6401 LINCOLN AVENUE
RIVERSIDE CA
92506-2037
US

IV. Provider business mailing address

6401 LINCOLN AVE
RIVERSIDE CA
92506-4424
US

V. Phone/Fax

Practice location:
  • Phone: 951-683-6596
  • Fax: 951-683-4239
Mailing address:
  • Phone: 951-683-6596
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State

VIII. Authorized Official

Name: CRAIG LAMBDIN
Title or Position: DIRECTOR
Credential:
Phone: 951-683-6596