Provider Demographics
NPI:1346419660
Name:UNIFIED SUPPORT SERVICES
Entity Type:Organization
Organization Name:UNIFIED SUPPORT SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:LISA
Authorized Official - Middle Name:MCLAUGHLIN
Authorized Official - Last Name:GRAY
Authorized Official - Suffix:
Authorized Official - Credentials:BA
Authorized Official - Phone:336-987-6631
Mailing Address - Street 1:1101 N ELM ST
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27401-1327
Mailing Address - Country:US
Mailing Address - Phone:336-987-6631
Mailing Address - Fax:
Practice Address - Street 1:1101 N ELM ST
Practice Address - Street 2:SUITE 501
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27401-1327
Practice Address - Country:US
Practice Address - Phone:336-987-6631
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-21
Last Update Date:2008-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No251B00000XAgenciesCase Management