Habilitation and Support Services, Inc

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

HABILITATION AND SUPPORT SERVICES, INC

Practice address

704 W Warren St
Shelby, NC 28150-5022

Phone

(704) 482-0299

Fax

(704) 487-5635

NPI assigned

Jun 20, 2007

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Tanzy B. Wallace

Title

Director of Operations

Phone

(704) 482-0299

Specialties & licenses 1

Addresses

Other identifiers 1

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1182297600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1124223946",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 596",
            "city": "SHELBY",
            "state": "NC",
            "postal_code": "281510596",
            "telephone_number": "704-482-0299",
            "fax_number": "704-487-5635"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "704 W WARREN ST",
            "city": "SHELBY",
            "state": "NC",
            "postal_code": "281505022",
            "telephone_number": "704-482-0299",
            "fax_number": "704-487-5635"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HABILITATION AND SUPPORT SERVICES, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-20",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WALLACE",
        "authorized_official_first_name": "TANZY",
        "authorized_official_middle_name": "B.",
        "authorized_official_title_or_position": "DIRECTOR OF OPERATIONS",
        "authorized_official_telephone_number": "704-482-0299",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8300178",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Taylor Guffey
• Katherine Ann Guilford, LCSW
• Bikash Gupta, MD
• Robert S Gustashaw, RPH
• Tyler Gyscek, PT, DPT
• Abigail Bradshaw Hager
• Tasha Hall-Cansler, OTR/L
• Clarissa Roberts Hall
• Robert Hall
• Stacey Denise Hall, MSPT

• Community/Behavioral Health Agency in Shelby, NC
• Providers in Shelby, NC by specialty
• Community/Behavioral Health Agency in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.