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General NPI Number Information
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NPI Number | 1760993992
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Entity Type | Organization
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Legal Business Name | CREATING EMPOWERMENT SERVICES
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Dates
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Enumeration Date | 10/15/2017
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Last Update Date | 10/15/2017
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Provider Practice Location Address
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Address Line | 4773 MADRID RIDGE CT
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City | LAS VEGAS
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State | NV
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Zip | 89129-3682
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Country | US
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Telephone | 702-487-1534
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Fax |
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Provider Business Mailing Address
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Address Line | 4773 MADRID RIDGE CT
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City | LAS VEGAS
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State | NV
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Zip | 89129-3682
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Country | US
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Telephone | 702-487-1534
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | SHAMEKA ROSHE DAVIS
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Credential |
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Telephone | 702-487-1534
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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 | 20171661504
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License Number State | NV
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