Organization
CREATIVE LIFE SKILLS DEVELOPMENT, INC
Active
Other names
Creative Life Skills Development, LLC
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LISA LYN HERRMANN MS OTR (OWNER)
(602) 441-5975
Entity
Organization
Contact information
Practice address
1941 E WESCOTT DR, PHOENIX, AZ 85024-2434
(602) 441-5975
(602) 485-8859
Mailing address
PO BOX 71726, PHOENIX, AZ 85050-1013
(602) 441-5975
(602) 485-8859
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
2762
AZ
Other
Enumeration date
04/23/2007
Last updated
08/22/2020
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