Provider Demographics
NPI:1568522902
Name:CREATE THERAPEUTIC SOLUTIONS, LLC
Entity Type:Organization
Organization Name:CREATE THERAPEUTIC SOLUTIONS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:MORRIS
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:PATZLAFF
Authorized Official - Suffix:
Authorized Official - Credentials:MSW
Authorized Official - Phone:605-275-5700
Mailing Address - Street 1:2121 W 63RD PL
Mailing Address - Street 2:SUITE 200
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57108-5058
Mailing Address - Country:US
Mailing Address - Phone:605-275-5700
Mailing Address - Fax:605-275-5777
Practice Address - Street 1:2121 W 63RD PL
Practice Address - Street 2:SUITE 200
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57108-5058
Practice Address - Country:US
Practice Address - Phone:605-275-5700
Practice Address - Fax:605-275-5777
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
SD6575042Medicaid