Provider Demographics
NPI:1790869964
Name:UNITY RESIDENTIAL SERVICE INC.
Entity Type:Organization
Organization Name:UNITY RESIDENTIAL SERVICE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:JEANETTE
Authorized Official - Last Name:GRANT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-879-8216
Mailing Address - Street 1:112 BARBOUR ST
Mailing Address - Street 2:
Mailing Address - City:CLAYTON
Mailing Address - State:NC
Mailing Address - Zip Code:27520-2402
Mailing Address - Country:US
Mailing Address - Phone:919-879-8216
Mailing Address - Fax:919-879-8479
Practice Address - Street 1:112 BARBOUR ST
Practice Address - Street 2:
Practice Address - City:CLAYTON
Practice Address - State:NC
Practice Address - Zip Code:27520-2402
Practice Address - Country:US
Practice Address - Phone:919-879-8216
Practice Address - Fax:919-879-8479
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-24
Last Update Date:2013-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCMHL051149320600000X
NCMHL051180320600000X
NCMHL051171320600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities