| Organization Name: | CREATIVE LIVING CENETER, INC. |
| NPI Number: | 1356597843 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | KATHY HAMM (DIRECTOR) |
| Mailing Address: | 434 Allegheny River Blvd Suite 215 Oakmont |
| State: | PA US |
| Postal Code: | 151391734 |
| Phone Number: | 4128289459 |
| Fax Number: | |
| NPI Enumeration Date: | 08/15/2008 |
| NPI Last Update Date: | 08/15/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC0700X |
| License Number: | PS005025L |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | PA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | |