Provider Demographics
NPI:1548601545
Name:SUPPORT SOLUTIONS OF THE MIDSOUTH LLC
Entity Type:Organization
Organization Name:SUPPORT SOLUTIONS OF THE MIDSOUTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:DR
Authorized Official - First Name:LARRY
Authorized Official - Middle Name:
Authorized Official - Last Name:DURBIN
Authorized Official - Suffix:
Authorized Official - Credentials:EDD
Authorized Official - Phone:901-383-9193
Mailing Address - Street 1:24 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:BURNSVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28714-2925
Mailing Address - Country:US
Mailing Address - Phone:828-682-2220
Mailing Address - Fax:877-749-3885
Practice Address - Street 1:24 N MAIN ST
Practice Address - Street 2:
Practice Address - City:BURNSVILLE
Practice Address - State:NC
Practice Address - Zip Code:28714-2925
Practice Address - Country:US
Practice Address - Phone:828-682-2220
Practice Address - Fax:877-749-3885
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-08
Last Update Date:2013-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No253Z00000XAgenciesIn Home Supportive Care