Organization
CREATIVE INNERVISIONS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. LILLIAN R DAVIS (OWNER/ MANAGING DIRCETOR)
(602) 265-8007
Entity
Organization
Contact information
Practice address
1616 E INDIAN SCHOOL RD STE 415, PHOENIX, AZ 85016-8604
(602) 265-8007
(602) 265-8013
Mailing address
1616 E INDIAN SCHOOL RD STE 415, PHOENIX, AZ 85016-8604
(602) 265-8007
(602) 265-8013
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
—
AZ
320800000X
Mental Illness Community Based Residential Treatment Facility
—
AZ
Other
Enumeration date
03/01/2012
Last updated
03/01/2012
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