Provider Demographics
NPI:1790806172
Name:CREATINGOPTIONSLLC
Entity Type:Organization
Organization Name:CREATINGOPTIONSLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AGENCY DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:STEVE
Authorized Official - Middle Name:K
Authorized Official - Last Name:RILEY
Authorized Official - Suffix:
Authorized Official - Credentials:BA
Authorized Official - Phone:208-587-8095
Mailing Address - Street 1:PO BOX 1083
Mailing Address - Street 2:
Mailing Address - City:MOUNTAIN HOME
Mailing Address - State:ID
Mailing Address - Zip Code:83647-1083
Mailing Address - Country:US
Mailing Address - Phone:208-587-8095
Mailing Address - Fax:208-587-8025
Practice Address - Street 1:2390 AMERICAN LEGION BLVD
Practice Address - Street 2:SUITE 2
Practice Address - City:MOUNTAIN HOME
Practice Address - State:ID
Practice Address - Zip Code:83647-3109
Practice Address - Country:US
Practice Address - Phone:208-587-8095
Practice Address - Fax:208-587-8025
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ID251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health