| Creative Life Behavioral Health Service | |
|
5175 Camino Al Norte Las Vegas NV 89031 | |
| (702) 648-3913 | |
| Not Available |
| Full Name | Creative Life Behavioral Health Service |
|---|---|
| Speciality | Counselor |
| Location | 5175 Camino Al Norte, Las Vegas, Nevada |
| Authorized Official Name and Position | Ieasha Nicole Pettus (BST) |
| Authorized Official Contact | 7026430713 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Creative Life Behavioral Health Service 5175 Camino Al Norte North Las Vegas NV 89031-2407 Ph: (702) 648-3913 | Creative Life Behavioral Health Service 5175 Camino Al Norte Las Vegas NV 89031 Ph: (702) 648-3913 |
| NPI Number | 1932446069 |
|---|---|
| Provider Enumeration Date | 01/09/2013 |
| Last Update Date | 01/09/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932446069 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101Y00000X | Counselor | 570574888 (California) | Primary |
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