Creative Living Support Services LLC
Clinic/Center, Developmental Disabilities in East Orange, NJ. Organization (NPI-2).
NPI number1982309738
StatusActive
Last updated in NPPESNov 18, 2024
Details
- NPI
- 1982309738
- Entity type
- Organization (NPI-2)
- Legal business name
- Creative Living Support Services LLC
- Organization subpart
- No
- Enumeration date
- Apr 3, 2023
- Certification date
- Nov 18, 2024
- Last updated
- Nov 18, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QD1600X | Clinic/Center, Developmental Disabilities | – | – | Yes |
| 251B00000X | Case Management | – | – | |
| 251E00000X | Home Health | – | – | |
| 251S00000X | Community/Behavioral Health | – | – | |
| 251X00000X | Supports Brokerage | – | – | |
| 253Z00000X | In Home Supportive Care | – | – | |
| 261QM0801X | Clinic/Center, Mental Health (Including Community Mental Health Center) | – | – | |
| 261QM0850X | Clinic/Center, Adult Mental Health | – | – | |
| 261QM0855X | Clinic/Center, Adolescent and Children Mental Health | – | – | |
| 385H00000X | Respite Care | – | – | |
| 385HR2060X | Respite Care, Respite Care, Intellectual and/or Developmental Disabilities, Child | – | – |
Practice location
134 Evergreen Pl Ste 600East Orange, NJ 07018-2011
Phone 862-252-6752
Mailing address
134 Evergreen Pl Ste 600East Orange, NJ 07018-2011
Phone 862-252-6752
Other practice locations
101 S Elm St Ste 78
Greensboro, NC 27401-3051
Greensboro, NC 27401-3051
Phone 862-202-1878 · Fax 877-308-0406
Authorized official
Royleta S Foster
President
8622536722
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
Other Developmental Disabilities Clinic/Center providers in East Orange, NJ
Checking a whole list?
Paste up to 5,000 NPIs and download status, name, taxonomy, license and address for each one. Useful for credentialing, billing and pharmacy claim checks.