National Provider Identifier Database

CREATIVE SUPPORT SERVICES LLC
Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities

A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with intellectual and/or developmental disabilities


Contact Information

CREATIVE SUPPORT SERVICES, LLC
9893 DECATUR RD
MIDDLE RIVER, MD21220-3776
Phone: 443-326-5120
Fax:
Website:
Specialty Taxonomy Code
* Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities 320900000X

* Indicates primary specialty

NPI Profile & details for CREATIVE SUPPORT SERVICES, LLC

NPI Number 1245049949
Legal business name
LBN
CREATIVE SUPPORT SERVICES, LLC
Authorized official BERGEDA MINNIS - (EXECUTIVE DIRECTOR)
Entity Organization
Organization subpart No
Enumeration date 01/06/2025
Last updated 01/06/2025 - More than a year ago
Sole proprietor1 Not specified
Identifiers n/a

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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