Healthcare Provider Details

I. General information

NPI: 1982860029
Provider Name (Legal Business Name): UMAR SERVICES, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/29/2008
Last Update Date: 09/21/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19704 ZION AVE
CORNELIUS NC
28031-8494
US

IV. Provider business mailing address

5350 77 CENTER DR STE 201
CHARLOTTE NC
28217-2783
US

V. Phone/Fax

Practice location:
  • Phone: 704-892-4461
  • Fax: 704-892-4450
Mailing address:
  • Phone: 704-875-1328
  • Fax: 704-875-9276

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License NumberMHL0601036
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License NumberMHL-060-1036
License Number StateNC
# 3
Primary TaxonomyN
Taxonomy Code320600000X
TaxonomyIntellectual and/or Developmental Disabilities Residential Treatment Facility
License NumberMHL0601036
License Number StateNC

VIII. Authorized Official

Name: MARILYN GARNER
Title or Position: CEO AND PRESIDENT
Credential:
Phone: 704-659-7630