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CREATIVE COMMUNITY SERVICE INC. NPI 1891820130


NPI Information

NPI: 1891820130
Provider Name: CREATIVE COMMUNITY SERVICE, INC.
Classification: Community/Behavioral Health - 251S00000X
Entity Type: Organization
Address:
4487 PARK DR
SUITE A
NORCROSS, GA
ZIP 30093
Phone: (770) 469-6226
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CREATIVE COMMUNITY SERVICE, INC. is a community behavioral health in Norcross, GA. The provider is a private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, intellectual disabilities, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment. CREATIVE COMMUNITY SERVICE, INC. NPI is 1891820130. The provider is registered as an organization entity type.

The provider's business location address is:

4487 PARK DR
SUITE A
NORCROSS, GA
ZIP 30093-964
Phone: (770) 469-6226
Fax: (678) 894-4081

The provider's authorized official is Cathy Pallon .
The authorized official title is Chief Operating Officer and has the following contact phone number (770) 469-6226.

The enumeration date for this NPI number is 2/23/2007 and was last updated on 5/21/2008.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1251S00000XCommunity/Behavioral HealthCP-FC0040079GEORGIANo
2251C00000XDay Training, Developmentally Disabled Services060-R-0018GEORGIANo
3251S00000XCommunity/Behavioral Health060-R-0018GEORGIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1000565375ACMEDICAIDGEORGIA
2000565375ADMEDICAIDGEORGIA
3000565375AEMEDICAIDGEORGIA
4000565375ANMEDICAIDGEORGIA
5000565375BMEDICAIDGEORGIA
6000565375OMEDICAIDGEORGIA
7000565375SMEDICAIDGEORGIA
8000565375ABMEDICAIDGEORGIA
9000565375AKMEDICAIDGEORGIA
10000565375GMEDICAIDGEORGIA
11000565375IMEDICAIDGEORGIA
12000565375VMEDICAIDGEORGIA
13000565375XMEDICAIDGEORGIA
14000565375AFMEDICAIDGEORGIA
15000565375RMEDICAIDGEORGIA
16000565375WMEDICAIDGEORGIA
17000565375AJMEDICAIDGEORGIA
18000565375ALMEDICAIDGEORGIA
19000565375UMEDICAIDGEORGIA
20000565375YMEDICAIDGEORGIA
21000565375AIMEDICAIDGEORGIA
22000565375LMEDICAIDGEORGIA
23000565375NMEDICAIDGEORGIA
24000565375PMEDICAIDGEORGIA
25000565375QMEDICAIDGEORGIA
26300025237-CMEDICAIDGEORGIA
27000565375AGMEDICAIDGEORGIA
28000565375AHMEDICAIDGEORGIA
29000565375HMEDICAIDGEORGIA
30000565375AAMEDICAIDGEORGIA
31000565375AMMEDICAIDGEORGIA
32000565375FMEDICAIDGEORGIA
33000565375JMEDICAIDGEORGIA
34000565375KMEDICAIDGEORGIA
35000565375MMEDICAIDGEORGIA
36000565375TMEDICAIDGEORGIA
37000565375ZMEDICAIDGEORGIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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