Provider Demographics
NPI:1912218611
Name:CAROLINA SUPPORT SERVICES, INC
Entity Type:Organization
Organization Name:CAROLINA SUPPORT SERVICES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:HESTER
Authorized Official - Last Name:SPRUILL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:252-347-4244
Mailing Address - Street 1:925 CONFERENCE DR
Mailing Address - Street 2:D
Mailing Address - City:GREENVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27858-5971
Mailing Address - Country:US
Mailing Address - Phone:252-752-2002
Mailing Address - Fax:252-754-2008
Practice Address - Street 1:925 CONFERENCE DR
Practice Address - Street 2:D
Practice Address - City:GREENVILLE
Practice Address - State:NC
Practice Address - Zip Code:27858-5971
Practice Address - Country:US
Practice Address - Phone:252-752-2002
Practice Address - Fax:252-754-2008
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-28
Last Update Date:2014-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8302964GMedicaid
NC8703101Medicaid
NC8302964HMedicaid
NC8303247Medicaid
NC8303093RMedicaid
NC8303206HMedicaid
NC8303210Medicaid
NC891286VMedicaid
NC3410099Medicaid
NC6007638Medicaid
NC8303247HMedicaid
NC8303269Medicaid
NC8303269HMedicaid
NC6007483Medicaid
NC8302932RMedicaid
NC8301743GMedicaid
NC8303206Medicaid
NC8303210RMedicaid
NC8303095RMedicaid