Organization Active NPI

Amazing Community Support Inc

  • Community/Behavioral Health Agency
  • Fayetteville, NC
National Provider Identifier
1508000233
Registry record updated Apr 24, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
AMAZING COMMUNITY SUPPORT INC
Practice address
106 Hay St
Suite 210
Fayetteville, NC 28301-5650
Phone
(910) 630-2025
NPI assigned
Apr 24, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2009

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

Authorized official

Name
Karena Nelson
Title
President
Phone
(910) 630-2025

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X NC Primary

Addresses

Primary practice location

106 Hay St
Suite 210
Fayetteville, NC 28301-5650

Mailing address

106 Hay St
Suite 210
Fayetteville, NC 28301-5650
Phone (910) 630-2025

Other identifiers 1

IdentifierTypeStateIssuer
0000000MedicaidNC

National Provider Directory

National Provider Directory

Locations

106 Hay St
Ste 210
Fayetteville, NC 28301
Phone (910) 630-2025

NPI Registry JSON

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

{
    "created_epoch": "1240531200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1240531200000",
    "number": "1508000233",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "106 HAY ST",
            "address_2": "SUITE 210",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283015650",
            "telephone_number": "910-630-2025"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "106 HAY ST",
            "address_2": "SUITE 210",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283015650",
            "telephone_number": "910-630-2025"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMAZING COMMUNITY SUPPORT INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-04-24",
        "last_updated": "2009-04-24",
        "status": "A",
        "authorized_official_last_name": "NELSON",
        "authorized_official_first_name": "KARENA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "910-630-2025"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NC",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0000000",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2009; 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.