Healthcare Provider Details

I. General information

NPI: 1982175139
Provider Name (Legal Business Name): A&S HUMANS SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/16/2018
Last Update Date: 12/16/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1111 SOUTHLAND DR
ROCK HILL NC
29730
US

IV. Provider business mailing address

1111 SOUTHLAND DR
ROCK HILL NC
29730
US

V. Phone/Fax

Practice location:
  • Phone: 443-477-3150
  • Fax:
Mailing address:
  • Phone: 443-477-3150
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174200000X
TaxonomyMeals Provider
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code332U00000X
TaxonomyHome Delivered Meals
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: ADONIS BURRIS
Title or Position: CHIEF EXECUTIVE OFFICER
Credential:
Phone: 443-477-3150