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General NPI Number Information
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NPI Number | 1124223946
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Entity Type | Organization
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Legal Business Name | HABILITATION AND SUPPORT SERVICES, INC
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Dates
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Enumeration Date | 06/20/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 704 W WARREN ST
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City | SHELBY
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State | NC
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Zip | 28150-5022
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Country | US
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Telephone | 704-482-0299
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Fax | 704-487-5635
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Provider Business Mailing Address
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Address Line | PO BOX 596
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City | SHELBY
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State | NC
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Zip | 28151-0596
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Country | US
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Telephone | 704-482-0299
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Fax | 704-487-5635
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Authorized Official
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Title or Position | DIRECTOR OF OPERATIONS
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Name | MRS. TANZY B. WALLACE
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Credential |
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Telephone | 704-482-0299
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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