Provider Demographics
NPI:1144405259
Name:PERSONAL BEST SUPPORTIVE HELP SERVICES INC
Entity Type:Organization
Organization Name:PERSONAL BEST SUPPORTIVE HELP SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR, OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:TERRI
Authorized Official - Middle Name:KIM
Authorized Official - Last Name:YOUNG
Authorized Official - Suffix:
Authorized Official - Credentials:BA;QP
Authorized Official - Phone:336-351-4209
Mailing Address - Street 1:1195 DEARMIN RD
Mailing Address - Street 2:
Mailing Address - City:WESTFIELD
Mailing Address - State:NC
Mailing Address - Zip Code:27053-7104
Mailing Address - Country:US
Mailing Address - Phone:336-351-4209
Mailing Address - Fax:
Practice Address - Street 1:1195 DEARMIN RD
Practice Address - Street 2:
Practice Address - City:WESTFIELD
Practice Address - State:NC
Practice Address - Zip Code:27053-7104
Practice Address - Country:US
Practice Address - Phone:336-351-4209
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-08
Last Update Date:2008-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8302140GMedicaid
NC83202140BMedicaid