| Community Support Professionals, Llc | |
|
1606 Wellington Ave Ste C Wilmington NC 28401-7704 | |
| (910) 799-4505 | |
| (910) 799-4345 |
| Full Name | Community Support Professionals, Llc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 1606 Wellington Ave Ste C, Wilmington, North Carolina |
| Authorized Official Name and Position | Charles Christopher Creech (CEO) |
| Authorized Official Contact | 9107994505 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Community Support Professionals, Llc 1606 Wellington Ave Ste C Wilmington NC 28401-7704 Ph: (910) 799-4505 | Community Support Professionals, Llc 1606 Wellington Ave Ste C Wilmington NC 28401-7704 Ph: (910) 799-4505 |
| NPI Number | 1518165513 |
|---|---|
| Provider Enumeration Date | 07/11/2007 |
| Last Update Date | 07/11/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518165513 | NPI | - | NPPES |
| 8300728B | Medicaid | NC | |
| 8300728J | Medicaid | NC | |
| 8300728G | Medicaid | NC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 805 (North Carolina) | Primary |
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