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General NPI Number Information
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NPI Number | 1225302425
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Entity Type | Organization
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Legal Business Name | CREATIVE DIRECTIONS INC.
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Dates
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Enumeration Date | 03/06/2012
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Last Update Date | 02/18/2021
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Provider Practice Location Address
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Address Line | 427 MAPLE AVE
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City | BURLINGTON
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State | NC
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Zip | 27215-5933
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Country | US
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Telephone | 336-539-1015
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Fax | 888-234-8655
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Provider Business Mailing Address
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Address Line | PO BOX 1029
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City | BURLINGTON
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State | NC
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Zip | 27216-1029
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Country | US
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Telephone | 336-586-1886
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Fax | 888-234-8655
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Authorized Official
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Title or Position | BUSINESS MANAGER
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Name | MR. JOHN HAITH GRAVES
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Credential |
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Telephone | 919-812-5547
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 320600000X
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Taxonomy Name | Intellectual and/or Developmental Disabilities Residential Treatment Facility
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License Number | MHL-001-223
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License Number State | NC
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Taxonomy #3
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Taxonomy Code | 320800000X
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Taxonomy Name | Mental Illness Community Based Residential Treatment Facility
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License Number |
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License Number State |
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