MEDICARE: CREATIVE COLLABORATION

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	104100000X	Social Worker
2	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1003109802
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CREATIVE COLLABORATION

Provider Business Mailing Address
First Line	:	8070 W RUSSELL RD
Second Line	:	APT 1065
City	:	LAS VEGAS
State	:	NV
Zip	:	89113-1549
Country	:	US
Telephone Number	:	702-610-4153
Fax Number	:

Provider Business Practice Location Address
First Line	:	8070 W RUSSELL RD
Second Line	:	APT 1065
City	:	LAS VEGAS
State	:	NV
Zip	:	89113-1549
Country	:	US
Telephone Number	:	702-610-4153
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	BONITO SAHAGUN
Credential	:
Telephone Number	:	702-610-4153

Provider Enumeration Date	:	05/26/2011
Last Update Date	:	05/26/2011

Similar Medicare Providers

1497064588 — MRS. SABRINA DANEEN DEVILLE
Practice Location Address:

8070 W RUSSELL RD , 2007
LAS VEGAS, NV
89113-1549

Practice Phone: 951-552-5254
Practice Fax:

1598208357 — JASON BENNETT
Practice Location Address:

8070 W RUSSELL RD , 1092
LAS VEGAS, NV
89113-1549

Practice Phone: 410-205-5292
Practice Fax:

1053119842 — DELL WHITE
Practice Location Address:

8070 W RUSSELL RD
LAS VEGAS, NV
89113-1549

Practice Phone: 818-642-5496
Practice Fax:

1689219792 — DEBORAH A NERO
Practice Location Address:

5800 BROMLEY AVE APT 32
LAS VEGAS, NV
89107-1549

Practice Phone: 530-309-5667
Practice Fax:

1942791678 — JERROD BURGAN
Practice Location Address:

1549 E LAS PALMARITAS DR
PHOENIX, AZ
85020-3854

Practice Phone: 419-612-6364
Practice Fax:

1649831645 — NEW METHOD WELLNESS, INC.
Practice Location Address:

34741 CALLE LAS FLORES
CAPISTRANO BEACH, CA
92624-1549

Practice Phone: 949-951-1824
Practice Fax:

Directions to “CREATIVE COLLABORATION ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.