Organization
CREATIVE LIVING CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHRISTINA HARDY (BUSINESS MANAGER)
(252) 757-0147
Entity
Organization
Contact information
Practice address
4748 STANTONSBURG RD, GREENVILLE, NC 27834-4794
(252) 757-0147
(252) 757-0147
Mailing address
PO BOX 948, GREENVILLE, NC 27835-0948
(252) 757-0147
(252) 757-0147
Taxonomy
Speciality
Code
Description
License number
State
261QA0600X
Adult Day Care Clinic/Center
Primary
—
—
385H00000X
Respite Care
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
261QA0600X
ADULT DAY CARE
NC
05
—
3409016
—
NC
Enumeration date
09/20/2007
Last updated
11/14/2024
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