Organization
COMMUNITY SUPPORT PROFESSIONALS,LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHARLES CHRISTOPHER CREECH (CEO)
(910) 799-4505
Entity
Organization
Contact information
Practice address
1606 WELLINGTON AVE UNITC, WILMINGTON, NC 28401-7704
(910) 799-4505
(910) 799-4345
Mailing address
1606 WELLINGTON AVE UNITC, WILMINGTON, NC 28401-7704
(910) 799-4505
(910) 799-4345
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
253Z00000X
In Home Supportive Care Agency
8300728H
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8300728
—
NC
Enumeration date
06/13/2006
Last updated
02/04/2009
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