Organization
CREATIVE LEARNING HOME CARE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TYRA DAVENPORT (SUPERVISOR)
(336) 286-9016
Entity
Organization
Contact information
Practice address
2820 LAWNDALE DR. 210, GREENSBORO, NC 27408-4132
(336) 286-9016
Mailing address
2820 LAWNDALE DR, 210, GREENSBORO, NC 27408-4132
(336) 286-9016
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
HC4221
NC
Other
Enumeration date
11/23/2010
Last updated
11/23/2010
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