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General NPI Number Information
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NPI Number | 1790806172
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Entity Type | Organization
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Legal Business Name | CREATINGOPTIONSLLC
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Dates
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Enumeration Date | 04/03/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2390 AMERICAN LEGION BLVD SUITE 2
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City | MOUNTAIN HOME
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State | ID
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Zip | 83647-3109
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Country | US
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Telephone | 208-587-8095
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Fax | 208-587-8025
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Provider Business Mailing Address
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Address Line | PO BOX 1083
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City | MOUNTAIN HOME
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State | ID
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Zip | 83647-1083
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Country | US
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Telephone | 208-587-8095
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Fax | 208-587-8025
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Authorized Official
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Title or Position | AGENCY DIRECTOR
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Name | MR. STEVE K RILEY
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Credential | BA
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Telephone | 208-587-8095
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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 | ID
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