Healthcare Provider Details

I. General information

NPI: 1669564340
Provider Name (Legal Business Name): CARING SUPPORT SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/29/2006
Last Update Date: 11/14/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

934 W 5TH ST
WINSTON SALEM NC
27101-2520
US

IV. Provider business mailing address

934 W 5TH ST
WINSTON SALEM NC
27101-2520
US

V. Phone/Fax

Practice location:
  • Phone: 336-761-2477
  • Fax: 336-761-2425
Mailing address:
  • Phone: 336-761-2477
  • Fax: 336-761-2425

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MS. DANA ALLEY
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 336-761-2477