Provider Demographics
NPI:1114204856
Name:A PLUS RESULTS INDEPENDENT LIVING, INC
Entity Type:Organization
Organization Name:A PLUS RESULTS INDEPENDENT LIVING, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DEDRIC
Authorized Official - Middle Name:
Authorized Official - Last Name:WILKINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:252-793-6500
Mailing Address - Street 1:PO BOX 685
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH
Mailing Address - State:NC
Mailing Address - Zip Code:27962-0685
Mailing Address - Country:US
Mailing Address - Phone:252-793-6500
Mailing Address - Fax:252-793-6501
Practice Address - Street 1:106 E WATER ST
Practice Address - Street 2:
Practice Address - City:PLYMOUTH
Practice Address - State:NC
Practice Address - Zip Code:27962-1330
Practice Address - Country:US
Practice Address - Phone:252-793-6500
Practice Address - Fax:252-793-6501
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-09
Last Update Date:2011-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No251B00000XAgenciesCase Management
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8303264Medicaid