SUPERIOR INNOVATIVE SERVICES II NPI 1104762996

NPI Information

  • NPI: 1104762996
  • Provider Name: SUPERIOR INNOVATIVE SERVICES II
  • Classification: Peer Specialist - 175T00000X
  • Entity Type: Organization
  • Address: 5000 BLUE CLAY RD STE D
    CASTLE HAYNE, NC
    ZIP 28429
  • Phone: (910) 352-9720

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NPI Details

SUPERIOR INNOVATIVE SERVICES II is a peer specialist in Castle Hayne, NC. The provider is individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority. SUPERIOR INNOVATIVE SERVICES II NPI is 1104762996. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

5000 BLUE CLAY RD STE D
CASTLE HAYNE, NC
ZIP 28429-302
Phone: (910) 352-9720

The provider's authorized official is Charles Davis .
The authorized official title is Ceo and has the following contact phone number (910) 352-9720.

The enumeration date for this NPI number is 4/25/2026 and was last updated on 4/25/2026.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1101YM0800XCounselorMental HealthNo
2251E00000XHome HealthNo
3251S00000XCommunity/Behavioral HealthNo
4332U00000XHome Delivered MealsNo
5343900000XNon-emergency Medical Transport (VAN)No
6347C00000XPrivate VehicleNo
7175T00000XPeer SpecialistYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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