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NPI Code Detail

MEDICARE: A STORM COMMUNITY SUPPORT

MEDICARE: A STORM COMMUNITY SUPPORT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1251B00000XCase Management Agency
2320600000XIntellectual and/or Developmental Disabilities Residential Treatment Facility
3253Z00000XIn Home Supportive Care Agency
4385H00000XRespite Care
5343900000XNon-emergency Medical Transport (VAN)
6174200000XMeals Provider
7320900000XIntellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
8291U00000XClinical Medical Laboratory
9320800000XMental Illness Community Based Residential Treatment Facility
10311ZA0620XAdult Care Home Facility
11276400000XSubstance Use Disorder Rehabilitation Hospital Unit
12347C00000XPrivate Vehicle
133747P1801XPersonal Care Attendant
14332U00000XHome Delivered Meals
15251S00000XCommunity/Behavioral Health Agency

General Provider Information

NPI Number : 1255086377
Entity Type Code : Organization
Provider Name (Legal Business Name) : A STORM COMMUNITY SUPPORT
Provider Business Mailing Address
First Line : 4801 GLENWOOD AVE STE 200
Second Line :
City : RALEIGH
State : NC
Zip : 27612-3857
Country : US
Telephone Number : 919-917-8330
Fax Number :
Provider Business Practice Location Address
First Line : 4801 GLENWOOD AVE STE 200
Second Line :
City : RALEIGH
State : NC
Zip : 27612-3857
Country : US
Telephone Number : 919-917-8330
Fax Number :
Authorized Official
Title or Position : PRESIDENT
Name : TIFFANY HILL
Credential :
Telephone Number : 919-917-8330
Provider Enumeration Date : 02/17/2022
Last Update Date : 12/09/2025

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1164070173 — GRACIE LYNNE MCCARROLL LCMHC
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Directions to “A STORM COMMUNITY SUPPORT ” Practice Location

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