Organization
CREOLIA'S HOUSE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LATONYA RICE (DIRECTOR)
(336) 634-0593
Entity
Organization
Contact information
Practice address
627 LAKE ST, EDEN, NC 27288-4323
(336) 635-4999
(336) 635-4999
Mailing address
1074 CANDY CREEK RD, REIDSVILLE, NC 27320-1631
(336) 634-0593
(336) 634-0593
Taxonomy
Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
—
NC
Other
Enumeration date
12/04/2007
Last updated
06/23/2008
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