Amazing Community Support Services Inc

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

AMAZING COMMUNITY SUPPORT SERVICES INC

Practice address

111 Lamon St
Fayetteville, NC 28301-4901

Phone

(910) 630-2025

Fax

(910) 630-2057

NPI assigned

Jan 12, 2009

Organization subpart

No

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

Authorized official

Name

Karena K Nelson

Title

Administrator

Phone

(910) 630-2025

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1231718400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1231718400000",
    "number": "1619114758",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 LAMON ST",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283014901",
            "telephone_number": "910-630-2025",
            "fax_number": "910-630-2057"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 LAMON ST",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283014901",
            "telephone_number": "910-630-2025",
            "fax_number": "910-630-2057"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMAZING COMMUNITY SUPPORT SERVICES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-01-12",
        "last_updated": "2009-01-12",
        "status": "A",
        "authorized_official_last_name": "NELSON",
        "authorized_official_first_name": "KARENA",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "910-630-2025"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "111111",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Amazing Grace Pca LLC
• Amazing Home Care Agency
• Amazing Home Care Agency Inc
• Amazing Home Care Agency LLC

• Community/Behavioral Health Agency in Fayetteville, NC
• Providers in Fayetteville, 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 Jan 12, 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.