| NPI | 1205075850 |
|---|---|
| Other Name | CLUB CREATIVE |
| Entity Type | Organization |
| Authorized Contact | KENNETH BURROW CEO 336-495-2700 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2009-02-05 |
| Last Update Date | 2009-02-05 |