RESIDENTIAL SUPPORT SERVICES NPI 1396177549

NPI Information

NPI: 1396177549
Provider Name: RESIDENTIAL SUPPORT SERVICES
Classification: Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities - 320900000X
Entity Type: Organization
Address:
3416 ATLANTIC AVE
RALEIGH, NC
ZIP 27604
Phone: (919) 787-1214
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RESIDENTIAL SUPPORT SERVICES is a community based residential treatment facility, intellectual and/or developmental disabilities in Raleigh, NC. The provider is a home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with mental retardation and/or developmental disabilities. RESIDENTIAL SUPPORT SERVICES NPI is 1396177549. The provider is registered as an organization entity type.

The provider's business location address is:

3416 ATLANTIC AVE
RALEIGH, NC
ZIP 27604-643
Phone: (919) 787-1214
Fax: (919) 787-3416

The provider's authorized official is Susan Murray .
The authorized official title is Executive Assistant and has the following contact phone number (919) 787-1214.

The enumeration date for this NPI number is 7/30/2013 and was last updated on 7/30/2013.

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
1	320900000X	Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities		MHL-092-474	NORTH CAROLINA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State
1	8702203	MEDICAID	NORTH CAROLINA
2	8300856B	MEDICAID	NORTH CAROLINA
3	8300856	MEDICAID	NORTH CAROLINA
4	3418153	MEDICAID	NORTH CAROLINA
5	7804508	MEDICAID	NORTH CAROLINA
6	7804509	MEDICAID	NORTH CAROLINA
7	7804510	MEDICAID	NORTH CAROLINA

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: 4/28/2024

NPI Synchronization or Removal

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