Habilitative Support Services, Inc.

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

HABILITATIVE SUPPORT SERVICES, INC.

Practice address

3985 Valley CT Apt D
Winston Salem, NC 27106-4397

Phone

(336) 577-2239

NPI assigned

Oct 23, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Antonio Lamar Caldwell

Title

Chairman and Ceo

Phone

(336) 577-2239

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1193097600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1193097600000",
    "number": "1902095235",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3985 VALLEY CT APT D",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271064397",
            "telephone_number": "336-577-2239"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3985 VALLEY CT APT D",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271064397",
            "telephone_number": "336-577-2239"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HABILITATIVE SUPPORT SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-23",
        "last_updated": "2007-10-23",
        "status": "A",
        "authorized_official_last_name": "CALDWELL",
        "authorized_official_first_name": "ANTONIO",
        "authorized_official_middle_name": "LAMAR",
        "authorized_official_title_or_position": "CHAIRMAN AND CEO",
        "authorized_official_telephone_number": "336-577-2239",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Community/Behavioral Health Agency in Winston Salem, NC
• Providers in Winston Salem, 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 Oct 23, 2007; 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.