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NPI Code Detail

MEDICARE: SUPPORTS PLUS LLC

MEDICARE: SUPPORTS PLUS LLC
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 AgencyNC
2252Y00000XEarly Intervention Provider AgencyNC
3253Z00000XIn Home Supportive Care AgencyNC
4251C00000XDevelopmentally Disabled Services Day Training AgencyNC

General Provider Information

NPI Number : 1548415987
Entity Type Code : Organization
Provider Name (Legal Business Name) : SUPPORTS PLUS LLC
Provider Business Mailing Address
First Line : 1310 E ARLINGTON BLVD
Second Line : SUITE A
City : GREENVILLE
State : NC
Zip : 27858-5868
Country : US
Telephone Number : 252-414-1347
Fax Number :
Provider Business Practice Location Address
First Line : 1310 E ARLINGTON BLVD
Second Line : SUITE A
City : GREENVILLE
State : NC
Zip : 27858-5868
Country : US
Telephone Number : 252-414-1347
Fax Number :
Authorized Official
Title or Position : PRESIDENT
Name : MR. PAUL ASHLEY BLEAU
Credential :
Telephone Number : 252-414-1347
Provider Enumeration Date : 11/26/2008
Last Update Date : 11/26/2008

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Directions to “SUPPORTS PLUS LLC ” Practice Location

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