Organization · NPI-2

Creative Community Living Services

Assisted Living Facility, Assisted Living, Mental Illness · Plano, TX

NPI number1942583125
StatusActive
Last updated in NPPESSep 23, 2011

Details

NPI
1942583125
Entity type
Organization (NPI-2)
Legal business name
Creative Community Living Services
Organization subpart
No
Enumeration date
Sep 23, 2011
Last updated
Sep 23, 2011

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
3104A0625X Assisted Living Facility, Assisted Living, Mental Illness––Yes

Practice location

1201 Legacy Dr
1913
Plano, TX 75023

Phone 214-440-2411 · Fax 214-440-2411

Mailing address

1201 Legacy Dr
1913
Plano, TX 75023

Phone 214-440-2411 · Fax 214-440-2411

Authorized official

Tracy Johnson
Owner
2144402411

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