=====================================================
General NPI Number Information
=====================================================
NPI Number | 1154711612
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | CREATE, INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/04/2015
-----------------------------------------------------
Last Update Date | 09/10/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 121-123 WEST 111TH STREET
-----------------------------------------------------
City | NEW YORK
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 10026
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 212-678-4990
-----------------------------------------------------
Fax | 212-665-1798
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 760 E 160TH ST
-----------------------------------------------------
City | BRONX
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 10456-7815
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 718-401-5700
-----------------------------------------------------
Fax | 718-993-5308
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CHIEF STRATEGY OFFICER
-----------------------------------------------------
Name | MR. DANIEL LOWY
-----------------------------------------------------
Credential | LCSW
-----------------------------------------------------
Telephone | 718-401-5650
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 324500000X
-----------------------------------------------------
Taxonomy Name | Substance Abuse Rehabilitation Facility
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------