Provider Demographics
NPI:1063653871
Name:CREATIVE TREATMENT SOLUTIONS LLC
Entity Type:Organization
Organization Name:CREATIVE TREATMENT SOLUTIONS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER & MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:L
Authorized Official - Last Name:WATTS
Authorized Official - Suffix:
Authorized Official - Credentials:LISW, LCSW
Authorized Official - Phone:440-409-8690
Mailing Address - Street 1:54 E 213TH ST
Mailing Address - Street 2:
Mailing Address - City:EUCLID
Mailing Address - State:OH
Mailing Address - Zip Code:44123-1065
Mailing Address - Country:US
Mailing Address - Phone:440-409-8690
Mailing Address - Fax:
Practice Address - Street 1:1305 W 80TH ST
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44102-6204
Practice Address - Country:US
Practice Address - Phone:440-409-8690
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-09
Last Update Date:2012-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI-1101288251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHH057831Medicare PIN
OHR72337Medicare UPIN