Provider Demographics
NPI:1740780436
Name:SUPPORT SERVICES UNLIMITED, LLC
Entity Type:Organization
Organization Name:SUPPORT SERVICES UNLIMITED, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:RICK
Authorized Official - Middle Name:
Authorized Official - Last Name:FERRELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-609-0219
Mailing Address - Street 1:PO BOX 89356
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33689-0405
Mailing Address - Country:US
Mailing Address - Phone:813-609-0219
Mailing Address - Fax:888-979-6989
Practice Address - Street 1:11929 TWILIGHT DARNER PL
Practice Address - Street 2:
Practice Address - City:RIVERVIEW
Practice Address - State:FL
Practice Address - Zip Code:33569-6513
Practice Address - Country:US
Practice Address - Phone:813-609-0219
Practice Address - Fax:888-979-6989
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-02-19
Last Update Date:2018-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD1600XAmbulatory Health Care FacilitiesClinic/CenterDevelopmental Disabilities
No251B00000XAgenciesCase Management