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General NPI Number Information
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NPI Number | 1063653871
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Entity Type | Organization
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Legal Business Name | CREATIVE TREATMENT SOLUTIONS LLC
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Dates
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Enumeration Date | 03/09/2009
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Last Update Date | 10/09/2012
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Provider Practice Location Address
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Address Line | 1305 W 80TH ST
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City | CLEVELAND
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State | OH
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Zip | 44102-6204
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Country | US
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Telephone | 440-409-8690
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Fax |
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Provider Business Mailing Address
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Address Line | 54 E 213TH ST
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City | EUCLID
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State | OH
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Zip | 44123-1065
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Country | US
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Telephone | 440-409-8690
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Fax |
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Authorized Official
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Title or Position | OWNER & MANAGER
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Name | MR. DAVID L. WATTS
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Credential | LISW, LCSW
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Telephone | 440-409-8690
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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 | I-1101288
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License Number State | OH
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