Provider Demographics
NPI:1700665445
Name:CREIGHTON OAKS TREATMENT SERVICES MANAGEMENT, LLC
Entity Type:Organization
Organization Name:CREIGHTON OAKS TREATMENT SERVICES MANAGEMENT, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:KONSTANTIN
Authorized Official - Middle Name:
Authorized Official - Last Name:SAVVON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-384-3908
Mailing Address - Street 1:697 EDGEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:TX
Mailing Address - Zip Code:77356-8431
Mailing Address - Country:US
Mailing Address - Phone:713-384-3908
Mailing Address - Fax:
Practice Address - Street 1:11313 LONG DR
Practice Address - Street 2:
Practice Address - City:CONROE
Practice Address - State:TX
Practice Address - Zip Code:77302
Practice Address - Country:US
Practice Address - Phone:713-384-3908
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-22
Last Update Date:2023-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty