Organization
CREATIVE LIVING SUPPORT SERVICES LLC
Active
Organization
CREATIVE LIVING SUPPORT SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. ROYLETA S FOSTER (PRESIDENT)
(862) 253-6722
Entity
Organization
Contact information
Practice address
134 EVERGREEN PL STE 600, EAST ORANGE, NJ 07018-2011
(862) 252-6752
Mailing address
134 EVERGREEN PL STE 600, EAST ORANGE, NJ 07018-2011
(862) 252-6752
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
—
251E00000X
Home Health Agency
—
—
251S00000X
Community/Behavioral Health Agency
—
—
251X00000X
Supports Brokerage Agency
—
—
253Z00000X
In Home Supportive Care Agency
—
—
261QD1600X
Developmental Disabilities Clinic/Center
Primary
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
385H00000X
Respite Care
—
—
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care
—
—
Other
Enumeration date
04/03/2023
Last updated
11/18/2024
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