NPIMap

Organization Active NPI

Creative Collaboration

  • Community/Behavioral Health Agency
  • Las Vegas, NV
National Provider Identifier
1003109802
Registry record updated May 26, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
CREATIVE COLLABORATION
Doing business as
CC Youth Empowerment Services
Practice address
8070 W Russell Rd
Apt 1065
Las Vegas, NV 89113-1549
Phone
(702) 610-4153
NPI assigned
May 26, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 26, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Bonito Sahagun
Title
President
Phone
(702) 610-4153

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 104100000X
Community/Behavioral Health Agency 251S00000X Primary

Addresses

Primary practice location

8070 W Russell Rd
Apt 1065
Las Vegas, NV 89113-1549

Mailing address

8070 W Russell Rd
Apt 1065
Las Vegas, NV 89113-1549
Phone (702) 610-4153

Other names 1

  • CC Youth Empowerment Services Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1306368000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1306368000000",
    "number": "1003109802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8070 W RUSSELL RD",
            "address_2": "APT 1065",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891131549",
            "telephone_number": "702-610-4153"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8070 W RUSSELL RD",
            "address_2": "APT 1065",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891131549",
            "telephone_number": "702-610-4153"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CREATIVE COLLABORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-05-26",
        "last_updated": "2011-05-26",
        "status": "A",
        "authorized_official_last_name": "SAHAGUN",
        "authorized_official_first_name": "BONITO",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "702-610-4153"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CC Youth Empowerment Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Las Vegas, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.