Provider Demographics
NPI:1851534937
Name:A PLUS COMMUNITY SUPPORT
Entity Type:Organization
Organization Name:A PLUS COMMUNITY SUPPORT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER/QP
Authorized Official - Prefix:MR
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:T
Authorized Official - Last Name:DAVIS
Authorized Official - Suffix:
Authorized Official - Credentials:MAED
Authorized Official - Phone:704-644-7103
Mailing Address - Street 1:PO BOX 241881
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28224-1881
Mailing Address - Country:US
Mailing Address - Phone:704-644-7103
Mailing Address - Fax:
Practice Address - Street 1:15720 JOHN J DELANEY DR
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28277-3430
Practice Address - Country:US
Practice Address - Phone:704-644-7103
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-20
Last Update Date:2009-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management