Organization Active NPI

Creative Living Center

  • Adult Day Care Clinic/Center
  • Greenville, NC
National Provider Identifier
1154517480
Registry record updated Nov 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Day Care Clinic/CenterTaxonomy code 261QA0600X
Legal business name
CREATIVE LIVING CENTER
Practice address
4748 Stantonsburg Rd
Greenville, NC 27834-4794
Phone
(252) 757-0147
Fax
(252) 757-0147
NPI assigned
Sep 20, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Christina Hardy
Title
Business Manager
Phone
(252) 757-0147

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Day Care Clinic/Center 261QA0600X Primary
Respite Care 385H00000X

Addresses

Primary practice location

4748 Stantonsburg Rd
Greenville, NC 27834-4794

Mailing address

PO Box 948
Greenville, NC 27835-0948
Phone (252) 757-0147

Other identifiers 2

IdentifierTypeStateIssuer
261QA0600XOtherNCADULT DAY CARE
3409016MedicaidNC

National Provider Directory

National Provider Directory

Locations

4748 Stantonsburg Rd
Greenville, NC 27834
Phone (252) 391-7993

901 Staton Rd
Greenville, NC 27834
Phone (800) 758-4188

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1190246400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1731542400000",
    "number": "1154517480",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 948",
            "city": "GREENVILLE",
            "state": "NC",
            "postal_code": "278350948",
            "telephone_number": "252-757-0147",
            "fax_number": "252-757-0147"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4748 STANTONSBURG RD",
            "city": "GREENVILLE",
            "state": "NC",
            "postal_code": "278344794",
            "telephone_number": "252-757-0147",
            "fax_number": "252-757-0147"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CREATIVE LIVING CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-20",
        "last_updated": "2024-11-14",
        "certification_date": "2024-11-14",
        "status": "A",
        "authorized_official_last_name": "HARDY",
        "authorized_official_first_name": "CHRISTINA",
        "authorized_official_title_or_position": "BUSINESS MANAGER",
        "authorized_official_telephone_number": "252-757-0147"
    },
    "taxonomies": [
        {
            "code": "261QA0600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Day Care",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "385H00000X",
            "taxonomy_group": "",
            "desc": "Respite Care",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ADULT DAY CARE",
            "identifier": "261QA0600X",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3409016",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.