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General NPI Number Information
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NPI Number | 1184152530
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Entity Type | Organization
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Legal Business Name | CREATIVE APPROACH RESIDENTIAL INC.
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Dates
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Enumeration Date | 05/30/2017
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Last Update Date | 05/30/2017
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Provider Practice Location Address
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Address Line | 5348 ALLOTT AVE.
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City | SHERMAN OAKS
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State | CA
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Zip | 91401
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Country | US
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Telephone | 818-905-1422
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Fax |
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Provider Business Mailing Address
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Address Line | 17609 VENTURA BLVD. SUITE #215
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City | ENCINO
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State | CA
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Zip | 91316
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Country | US
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Telephone | 818-905-1422
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Fax | 818-905-9968
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Authorized Official
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Title or Position | CEO
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Name | MR. ROBERT DANESHRAD
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Credential |
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Telephone | 818-905-1422
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0405X
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Taxonomy Name | Substance Use Disorder Rehabilitation Clinic/Center
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License Number |
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License Number State |
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