Healthcare Provider Details

I. General information

NPI: 1073769071
Provider Name (Legal Business Name): R AND R SUPPORT SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/11/2008
Last Update Date: 08/11/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11105 AMUR CT
CHARLOTTE NC
28262-2560
US

IV. Provider business mailing address

11105 AMUR CT
CHARLOTTE NC
28262-2560
US

V. Phone/Fax

Practice location:
  • Phone: 704-201-4472
  • Fax: 704-503-5812
Mailing address:
  • Phone: 704-201-4472
  • Fax: 704-503-5812

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MR. ROBERT ELDON CASTLE
Title or Position: PRESIDENT/CEO
Credential: M. ED.
Phone: 704-201-4472