| Creative Custom Living, Inc. | |
|
6010 Davis Mill Rd Greensboro NC 27406-9129 | |
| (336) 674-7751 | |
| (336) 674-6336 |
| Full Name | Creative Custom Living, Inc. |
|---|---|
| Speciality | Clinic/center - Adult Mental Health |
| Location | 6010 Davis Mill Rd, Greensboro, North Carolina |
| Authorized Official Name and Position | Jerry A. Allred (DIRECTOR) |
| Authorized Official Contact | 3366747751 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Creative Custom Living, Inc. Po Box 638 Pleasant Garden NC 27313-0638 Ph: (336) 674-7751 | Creative Custom Living, Inc. 6010 Davis Mill Rd Greensboro NC 27406-9129 Ph: (336) 674-7751 |
| NPI Number | 1528243219 |
|---|---|
| Provider Enumeration Date | 01/01/2008 |
| Last Update Date | 01/02/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1528243219 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | MHL-041-845 (North Carolina) | Primary |
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