Provider Demographics
NPI:1871644773
Name:HOWELL SUPPORT SERVICES
Entity Type:Organization
Organization Name:HOWELL SUPPORT SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:JERALD
Authorized Official - Middle Name:
Authorized Official - Last Name:HOWELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-778-1506
Mailing Address - Street 1:PO BOX 10946
Mailing Address - Street 2:
Mailing Address - City:GOLDSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27532-0946
Mailing Address - Country:US
Mailing Address - Phone:919-778-1506
Mailing Address - Fax:919-778-1535
Practice Address - Street 1:741 NC 24 50 HWY
Practice Address - Street 2:
Practice Address - City:KENANSVILLE
Practice Address - State:NC
Practice Address - Zip Code:28349-8954
Practice Address - Country:US
Practice Address - Phone:910-236-0554
Practice Address - Fax:910-293-9370
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8301215Medicaid