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Organization

CREATIVE LIFE

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. ORLANDO DIAZ (CASE MANAGER)
(602) 291-5863
Entity
Organization

Contact information

Practice address
2443 N 37TH WAY, PHOENIX, AZ 85008-2219
(602) 291-5863
Mailing address
2443 N 37TH WAY, PHOENIX, AZ 85008-2219
(602) 291-5863

Taxonomy

Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
X
NV

Other

Enumeration date
12/04/2012
Last updated
07/21/2022
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