Organization
A CREATIVE TRANSITION LIVING FACILITY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. NATALIA GONZALEZ (OWNER)
(336) 417-3751
Entity
Organization
Contact information
Practice address
215 W RUFFIN ST, BURLINGTON, NC 27217-2643
(336) 417-3751
Mailing address
215 W RUFFIN ST, BURLINGTON, NC 27217-2643
(336) 417-3751
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
—
—
310400000X
Assisted Living Facility
—
—
3104A0625X
Assisted Living Facility (Mental Illness)
—
—
3104A0630X
Assisted Living Facility (Behavioral Disturbances)
—
—
310500000X
Mental Illness Intermediate Care Facility
—
—
311ZA0620X
Adult Care Home Facility
—
—
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
—
—
320800000X
Mental Illness Community Based Residential Treatment Facility
—
—
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
—
—
385H00000X
Respite Care
—
—
Other
Enumeration date
06/10/2024
Last updated
06/10/2024
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