A-1 Community Support LLC

Organization Active NPI Community/Behavioral Health Agency · Henderson, NC

NPI 1609926112 · NPPES record last updated Jan 22, 2009

Key facts

NPI
1609926112
Entity type
Organization (NPI type 2)
Primary specialty
Community/Behavioral Health Agency 251S00000X
Legal business name
A-1 COMMUNITY SUPPORT LLC
Practice address
523 S Chestnut St
Henderson, NC 27536-4102
Phone
(252) 433-0255
Fax
(252) 436-6575
NPI assigned
Jan 10, 2007
Organization subpart
No

Authorized official

Name
Mr. Dwaylon Vondwell Whitley
Title
Owner
Phone
(919) 649-4757

Corporate family (same tax ID) 2

Organizations that report the same tax identification number in the National Provider Directory.

National Provider Directory

Tax ID family
A-1 Community Support LLC (3 organizations share this tax ID)

Locations

523 S Chestnut St
Henderson, NC 27536
Phone (252) 433-0255

Specialties & licenses

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

Addresses

Primary practice location

523 S Chestnut St
Henderson, NC 27536-4102

Mailing address

523 S Chestnut St
Henderson, NC 27536-4102
Phone (252) 433-0255

Other identifiers

IdentifierTypeStateIssuer
8302336MedicaidNC

Other providers in Henderson, NC

All providers in Henderson, NC · Community/Behavioral Health Agency in North Carolina

Sources for this page

Verify at the official NPI Registry.