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General NPI Number Information
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NPI Number | 1942093893
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Entity Type | Organization
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Legal Business Name | COMMUNITY CARE SUPPORT SERVICES INC
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Dates
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Enumeration Date | 05/23/2025
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Last Update Date | 05/23/2025
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Provider Practice Location Address
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Address Line | 517 S NORWOOD ST
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City | WALLACE
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State | NC
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Zip | 28466-1619
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Country | US
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Telephone | 910-779-7800
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Fax |
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Provider Business Mailing Address
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Address Line | 517 S NORWOOD ST
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City | WALLACE
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State | NC
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Zip | 28466-1619
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Country | US
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Telephone | 910-779-7800
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Fax |
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Authorized Official
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Title or Position | AUTHORIZED OFFICIAL
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Name | BRANDON HALL
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Credential |
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Telephone | 910-779-7800
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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