Healthcare Provider Details

I. General information

NPI: 1831245489
Provider Name (Legal Business Name): SPECIALIZED TREATMENT AND AFFILIATED RESOURCES, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/26/2007
Last Update Date: 09/13/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

375 E 3RD ST STE 202
WENDELL NC
27591-9708
US

IV. Provider business mailing address

375 E. THIRD STREET SUITE 202
WENDELL NC
27591
US

V. Phone/Fax

Practice location:
  • Phone: 919-365-9096
  • Fax: 919-365-9097
Mailing address:
  • Phone: 919-365-9096
  • Fax: 919-365-9097

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License NumberHC3515
License Number StateNC

VIII. Authorized Official

Name: MRS. SHARON EVETTE MOORE
Title or Position: DIRECTOR
Credential:
Phone: 919-365-9096