Healthcare Provider Details

I. General information

NPI: 1003319302
Provider Name (Legal Business Name): UNIVERSAL MENTAL HEALTH SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/13/2018
Last Update Date: 07/31/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2539 HYDE STREET
BURLINGTON NC
27217
US

IV. Provider business mailing address

839 WILKESBORO BLVD NE
LENOIR NC
28645-4612
US

V. Phone/Fax

Practice location:
  • Phone: 919-872-3888
  • Fax: 919-872-3322
Mailing address:
  • Phone: 828-759-2228
  • Fax: 828-759-0159

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License NumberMHL-001-254
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: HEATHER EVERHART
Title or Position: ACCOUNTING MANAGER
Credential:
Phone: 828-759-2228