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General NPI Number Information
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NPI Number | 1013153113
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Entity Type | Organization
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Legal Business Name | CENTER FOR CREATIVE THERAPEUTIC ARTS
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Dates
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Enumeration Date | 12/20/2008
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Last Update Date | 12/20/2008
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Provider Practice Location Address
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Address Line | 6375 W CHARLESTON BLVD BLDG L
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City | LAS VEGAS
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State | NV
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Zip | 89146-1139
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Country | US
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Telephone | 702-363-8166
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Fax | 702-315-4362
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Provider Business Mailing Address
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Address Line | 6375 W CHARLESTON BLVD STE 200
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City | LAS VEGAS
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State | NV
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Zip | 89146-1169
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Country | US
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Telephone | 702-363-8166
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Fax | 702-315-4362
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MS. JUDITH PINKERTON
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Credential | MT-BC
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Telephone | 702-363-8166
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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