Healthcare Provider Details
I. General information
NPI: 1083892848
Provider Name (Legal Business Name): UMAR SERVICES, INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 02/04/2008
Last Update Date: 09/21/2017
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1400 SPRING TREE CT
HIGH POINT NC
27265-9356
US
IV. Provider business mailing address
5350 77 CENTER DR STE 201
CHARLOTTE NC
28217-2783
US
V. Phone/Fax
- Phone: 338-883-6212
- Fax: 336-869-2529
- Phone: 704-875-1328
- Fax: 704-875-9276
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 251S00000X |
| Taxonomy | Community/Behavioral Health Agency |
| License Number | MHL-041-576 |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 320600000X |
| Taxonomy | Intellectual and/or Developmental Disabilities Residential Treatment Facility |
| License Number | MHL-041-576 |
| License Number State | NC |
VIII. Authorized Official
Name:
MARILYN
GARNER
Title or Position: CEO AND PRESIDENT
Credential:
Phone: 704-659-7630