| Organization Name: | COMMUNITY SUPPORT PROFESSIONALS,LLC |
| NPI Number: | 1174566905 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | CHARLES CHRISTOPHER CREECH (CEO) |
| Mailing Address: | 1606 Wellington Ave Unitc Wilmington |
| State: | NC US |
| Postal Code: | 284017704 |
| Phone Number: | 9107994505 |
| Fax Number: | 9107994345 |
| NPI Enumeration Date: | 06/13/2006 |
| NPI Last Update Date: | 02/04/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 253Z00000X |
| License Number: | 8300728H |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | NC |
| Taxonomy Type: | Agencies |
| Taxonomy Classification: | In Home Supportive Care |
| Taxonomy Specialization: | |
| Taxonomy Definition: | An In Home Supportive Care Agency provides services in the patient |