Provider Demographics
NPI:1366678997
Name:ALLIANCE OF AIDS SERVICES-CAROLINA
Entity Type:Organization
Organization Name:ALLIANCE OF AIDS SERVICES-CAROLINA
Other - Org Name:AAS-C
Other - Org Type:Other Name
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:JACQUELYN
Authorized Official - Middle Name:
Authorized Official - Last Name:CLYMORE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-834-2437
Mailing Address - Street 1:PO BOX 12583
Mailing Address - Street 2:324 SOUTH HARRINGTON STREET
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27605-2583
Mailing Address - Country:US
Mailing Address - Phone:919-834-2437
Mailing Address - Fax:919-834-3404
Practice Address - Street 1:324 S HARRINGTON ST
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27603-1847
Practice Address - Country:US
Practice Address - Phone:919-834-2437
Practice Address - Fax:919-834-3404
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-10
Last Update Date:2009-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
No251S00000XAgenciesCommunity/Behavioral Health