Organization
CREATIVE SUPPORT SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. BERGEDA MONIQUE MINNIS (EXECUTIVE DIRECTOR)
(443) 326-5120
Entity
Organization
Contact information
Practice address
9893 DECATUR RD, MIDDLE RIVER, MD 21220-3776
(443) 326-5120
Mailing address
9893 DECATUR RD, MIDDLE RIVER, MD 21220-3776
(443) 326-5120
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
01/06/2025
Last updated
01/06/2025
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