Organization
CREATIVE COLLABORATION
Active
Other names
CC Youth Empowerment Services
Organization subpart
No
Provider details
NPI number
Authorized official
BONITO SAHAGUN (PRESIDENT)
(702) 610-4153
Entity
Organization
Contact information
Practice address
8070 W RUSSELL RD, APT 1065, LAS VEGAS, NV 89113-1549
(702) 610-4153
Mailing address
8070 W RUSSELL RD, APT 1065, LAS VEGAS, NV 89113-1549
(702) 610-4153
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
05/26/2011
Last updated
05/26/2011
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