Provider Demographics
NPI:1811044290
Name:FOCUS SUPPORT GROUP INC.
Entity Type:Organization
Organization Name:FOCUS SUPPORT GROUP INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:MONDAY
Authorized Official - Middle Name:CHINEYEZE
Authorized Official - Last Name:ONUOHA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-662-9179
Mailing Address - Street 1:857 PLAZA LN
Mailing Address - Street 2:
Mailing Address - City:MOORESVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28115-9555
Mailing Address - Country:US
Mailing Address - Phone:704-662-9179
Mailing Address - Fax:704-663-1509
Practice Address - Street 1:375 VIRGINIA AVE
Practice Address - Street 2:
Practice Address - City:CHINA GROVE
Practice Address - State:NC
Practice Address - Zip Code:28023-8539
Practice Address - Country:US
Practice Address - Phone:704-855-3853
Practice Address - Fax:704-663-1509
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCMHL-080-141320600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC3409409Medicaid