Provider Demographics
NPI:1629248810
Name:SUPPORTS UNLIMITED INC.
Entity Type:Organization
Organization Name:SUPPORTS UNLIMITED INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:TAMMY
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:CORNETT
Authorized Official - Suffix:
Authorized Official - Credentials:RN, CCM
Authorized Official - Phone:606-378-2319
Mailing Address - Street 1:PO BOX 971
Mailing Address - Street 2:
Mailing Address - City:BULAN
Mailing Address - State:KY
Mailing Address - Zip Code:41722-0971
Mailing Address - Country:US
Mailing Address - Phone:606-378-2319
Mailing Address - Fax:
Practice Address - Street 1:230 SWARTZ DR
Practice Address - Street 2:SUITE 100
Practice Address - City:HAZARD
Practice Address - State:KY
Practice Address - Zip Code:41701-6808
Practice Address - Country:US
Practice Address - Phone:606-378-2319
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-04
Last Update Date:2008-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services