Organization
COMMUNITY SUPPORT PROFESSIONALS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHARLES CHRISTOPHER CREECH (CEO)
(910) 799-4505
Entity
Organization
Contact information
Practice address
1606 WELLINGTON AVE STE C, WILMINGTON, NC 28401-7704
(910) 799-4505
(910) 799-4345
Mailing address
1606 WELLINGTON AVE STE C, WILMINGTON, NC 28401-7704
(910) 799-4505
(910) 799-4345
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
805
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8300728B
—
NC
05
—
8300728G
—
NC
05
—
8300728J
—
NC
Enumeration date
07/11/2007
Last updated
07/11/2007
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