Provider Demographics
NPI:1104204833
Name:UNIVERSAL MENTAL HEALTH SERVICES, INC.
Entity Type:Organization
Organization Name:UNIVERSAL MENTAL HEALTH SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CONTROLLER
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:CARROLL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:828-759-4083
Mailing Address - Street 1:839 WILKESBORO BLVD NE
Mailing Address - Street 2:
Mailing Address - City:LENOIR
Mailing Address - State:NC
Mailing Address - Zip Code:28645-4612
Mailing Address - Country:US
Mailing Address - Phone:828-759-2228
Mailing Address - Fax:828-759-0159
Practice Address - Street 1:824 TANNERWELL AVE
Practice Address - Street 2:
Practice Address - City:WAKE FOREST
Practice Address - State:NC
Practice Address - Zip Code:27587-4688
Practice Address - Country:US
Practice Address - Phone:919-475-6660
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-14
Last Update Date:2015-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care