Creative Custom Living, Inc.

Primary specialty

Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X

License

MHL-041-845 Issued in NC

Legal business name

CREATIVE CUSTOM LIVING, INC.

Practice address

6010 Davis Mill Rd
Greensboro, NC 27406-9129

Phone

(336) 674-7751

Fax

(336) 674-6336

NPI assigned

Jan 1, 2008

Organization subpart

No

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

Authorized official

Name

Mr. Jerry A. Allred Sr.

Title

Director

Phone

(336) 674-7751

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1199145600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1199232000000",
    "number": "1528243219",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 638",
            "city": "PLEASANT GARDEN",
            "state": "NC",
            "postal_code": "273130638",
            "telephone_number": "336-674-7751",
            "fax_number": "336-674-6336"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6010 DAVIS MILL RD",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274069129",
            "telephone_number": "336-674-7751",
            "fax_number": "336-674-6336"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CREATIVE CUSTOM LIVING, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-01",
        "last_updated": "2008-01-02",
        "status": "A",
        "authorized_official_last_name": "ALLRED",
        "authorized_official_first_name": "JERRY",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "336-674-7751",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Sr."
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": "NC",
            "license": "MHL-041-845",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jill E Creacy, MS,CCC-SLP
• April Creason
• Jordan House Creasy, FNP-C
• Creative Care Solutions LLC
• Creative Counseling Works, LLC
• Creative Learning Home Care, LLC
• Creative Management Source, Inc.
• Crecer Speech and Language Therapy, PLLC
• Virginia Creed
• Brian Sanders Crenshaw, M.D.

• Adult Mental Health Clinic/Center in Greensboro, NC
• Providers in Greensboro, NC by specialty
• Adult Mental Health Clinic/Center in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2008; 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.