| NPI | 1508408725 |
|---|---|
| Doing Business As | CREO SPERO |
| Entity Type | Organization |
| Authorized Contact | MICHAEL RICHARD PRIESING Owner 657-342-0265 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Additional Taxonomies | 324500000X Substance Abuse Rehabilitation Facility |
| Enumeration Date | 2019-10-09 |
| Last Update Date | 2019-10-09 |