Healthcare Provider Details

I. General information

NPI: 1467416735
Provider Name (Legal Business Name): SPECIALIZED SERVICES & PERSONNEL, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/13/2006
Last Update Date: 06/01/2023
Certification Date: 05/31/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

301 N SYCAMORE ST
ABERDEEN NC
28315-2823
US

IV. Provider business mailing address

PO BOX 1356
ABERDEEN NC
28315-1356
US

V. Phone/Fax

Practice location:
  • Phone: 910-944-8125
  • Fax: 910-944-7705
Mailing address:
  • Phone: 910-944-8125
  • Fax: 910-944-7705

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code374700000X
TaxonomyTechnician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code3747A0650X
TaxonomyAttendant Care Provider
License NumberMHL0563052
License Number StateNC

VIII. Authorized Official

Name: KAREN STOCKWELL
Title or Position: FINANCE MANAGER
Credential:
Phone: 910-944-8125