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General NPI Number Information
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NPI Number | 1063788040
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Entity Type | Organization
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Legal Business Name | STANDARD ABOVE ALL, INC.
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Dates
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Enumeration Date | 03/23/2012
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Last Update Date | 03/23/2012
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Provider Practice Location Address
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Address Line | 656 HAGGERTY TRL
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City | ROCKY MOUNT
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State | NC
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Zip | 27803-9134
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Country | US
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Telephone | 252-210-3157
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Fax | 252-210-9171
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Provider Business Mailing Address
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Address Line | 200 BANNER WAY
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City | ROCKY MOUNT
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State | NC
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Zip | 27804-3456
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Country | US
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Telephone | 252-969-1934
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Fax | 252-210-9171
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Authorized Official
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Title or Position | OWNER/ADMINISTRATOR
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Name | MRS. SHANITTA RENEE BROOKS
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Credential | BSW, QP
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Telephone | 252-969-1934
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174H00000X
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Taxonomy Name | Health Educator
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License Number |
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 320600000X
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Taxonomy Name | Intellectual and/or Developmental Disabilities Residential Treatment Facility
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License Number |
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License Number State | NC
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Taxonomy #3
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Taxonomy Code | 320800000X
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Taxonomy Name | Mental Illness Community Based Residential Treatment Facility
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License Number |
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License Number State | NC
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Taxonomy #4
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Taxonomy Code | 385H00000X
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Taxonomy Name | Respite Care
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License Number |
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License Number State | NC
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Taxonomy #5
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Taxonomy Code | 320700000X
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Taxonomy Name | Physical Disabilities Residential Treatment Facility
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License Number |
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License Number State | NC
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