Provider Demographics
NPI:1568986800
Name:TOP PRIORITY CARE SERVICES, LLC.
Entity Type:Organization
Organization Name:TOP PRIORITY CARE SERVICES, LLC.
Other - Org Name:STANLEY COURT HOME
Other - Org Type:Other Name
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:P
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:LCSWA, LCASA
Authorized Official - Phone:336-896-1323
Mailing Address - Street 1:4401 PROVIDENCE LN
Mailing Address - Street 2:
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27106-3226
Mailing Address - Country:US
Mailing Address - Phone:336-896-1323
Mailing Address - Fax:336-896-1327
Practice Address - Street 1:4625 STANLEY CT
Practice Address - Street 2:
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27101
Practice Address - Country:US
Practice Address - Phone:336-777-7777
Practice Address - Fax:336-896-1327
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TOP PRIORITY CARE SERVICES, LLC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-07-28
Last Update Date:2018-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MHL-034-371253Z00000X
NC320600000X, 320900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities
No320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC3409668Medicaid