Provider Demographics
NPI:1053547240
Name:CREATIVE CARE SYSTEMS, INC.
Entity type:Organization
Organization Name:CREATIVE CARE SYSTEMS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:CAROL
Authorized Official - Middle Name:J
Authorized Official - Last Name:GRAHAM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-643-4443
Mailing Address - Street 1:800 N RAINBOW BLVD
Mailing Address - Street 2:SUITE 208
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89107-1189
Mailing Address - Country:US
Mailing Address - Phone:702-643-4443
Mailing Address - Fax:702-878-8761
Practice Address - Street 1:755 N ROOP ST
Practice Address - Street 2:SUITE 211
Practice Address - City:CARSON CITY
Practice Address - State:NV
Practice Address - Zip Code:89701-3113
Practice Address - Country:US
Practice Address - Phone:775-884-1400
Practice Address - Fax:775-884-1402
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-02
Last Update Date:2009-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No3104A0630XNursing & Custodial Care FacilitiesAssisted Living FacilityAssisted Living, Behavioral Disturbances
No310500000XNursing & Custodial Care FacilitiesIntermediate Care Facility, Mental Illness