Organization
CREATIVE COMMUNITY LIVING SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS TRACY JOHNSON (OWNER)
(214) 440-2411
Entity
Organization
Contact information
Practice address
1201 LEGACY DR, 1913, PLANO, TX 75023
(214) 440-2411
(214) 440-2411
Mailing address
1201 LEGACY DR, 1913, PLANO, TX 75023
(214) 440-2411
(214) 440-2411
Taxonomy
Speciality
Code
Description
License number
State
3104A0625X
Assisted Living Facility (Mental Illness)
Primary
—
—
Other
Enumeration date
09/23/2011
Last updated
09/23/2011
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