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NPI Code Detail

MEDICARE: CREATIVE CARE SYSTEMS, INC.

MEDICARE: CREATIVE CARE SYSTEMS, INC.
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
13104A0630XAssisted Living Facility (Behavioral Disturbances)
2310500000XMental Illness Intermediate Care Facility
3261QM0850XAdult Mental Health Clinic/Center

General Provider Information

NPI Number : 1053547240
Entity Type Code : Organization
Provider Name (Legal Business Name) : CREATIVE CARE SYSTEMS, INC.
Provider Business Mailing Address
First Line : 800 N RAINBOW BLVD
Second Line : SUITE 208
City : LAS VEGAS
State : NV
Zip : 89107-1189
Country : US
Telephone Number : 702-643-4443
Fax Number : 702-878-8761
Provider Business Practice Location Address
First Line : 755 N ROOP ST
Second Line : SUITE 211
City : CARSON CITY
State : NV
Zip : 89701-3113
Country : US
Telephone Number : 775-884-1400
Fax Number : 775-884-1402
Authorized Official
Title or Position : PRESIDENT
Name : MRS. CAROL J GRAHAM
Credential :
Telephone Number : 702-643-4443
Provider Enumeration Date : 06/02/2009
Last Update Date : 06/02/2009

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Directions to “CREATIVE CARE SYSTEMS, INC. ” Practice Location

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