Healthcare Provider Details

I. General information

NPI: 1154744902
Provider Name (Legal Business Name): UNIVERSAL MENTAL HEALTH SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/30/2014
Last Update Date: 06/05/2025
Certification Date: 06/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

541 SILVERLINER DR
KNIGHTDALE NC
27545-6611
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:
Mailing address:
  • Phone: 828-759-2228
  • Fax:

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

VIII. Authorized Official

Name: JENNIFER M CARROLL
Title or Position: CONTROLLER
Credential:
Phone: 828-759-4083