Organization
CREATIVE COMMUNITY SUPPORT, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. SALLAHDEEN SPRUILL (CEO)
(252) 413-0546
Entity
Organization
Contact information
Practice address
1206 EVANS ST STE 12, GREENVILLE, NC 27834-4102
(252) 413-0546
Mailing address
740 GREENVILLE BLVD SE STE 400, GREENVILLE, NC 27858-5135
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
11/21/2007
Last updated
11/29/2007
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