| Creative Community Support, Llc | |
|
1206 Evans St Ste 12 Greenville NC 27834-4102 | |
| (252) 413-0546 | |
| Not Available |
| Full Name | Creative Community Support, Llc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 1206 Evans St Ste 12, Greenville, North Carolina |
| Authorized Official Name and Position | Sallahdeen Spruill (CEO) |
| Authorized Official Contact | 2524130546 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Creative Community Support, Llc 740 Greenville Blvd Se Ste 400 Greenville NC 27858-5135 Ph: () - | Creative Community Support, Llc 1206 Evans St Ste 12 Greenville NC 27834-4102 Ph: (252) 413-0546 |
| NPI Number | 1518148279 |
|---|---|
| Provider Enumeration Date | 11/21/2007 |
| Last Update Date | 11/29/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518148279 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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