Organization
CREATIVE LIVING COMMUNITY SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEAN WHITE (EXECUTIVE DIRECTOR/FOUNDER)
(757) 717-8806
Entity
Organization
Contact information
Practice address
853 PARAPET RD, CHESAPEAKE, VA 23323-2419
(757) 717-8806
Mailing address
3212 ARMISTEAD DR, PORTSMOUTH, VA 23704-6104
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
08/12/2009
Last updated
08/12/2009
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