Provider Demographics
NPI: | 1255086377 |
---|---|
Name: | A STORM COMMUNITY SUPPORT |
Entity type: | Organization |
Organization Name: | A STORM COMMUNITY SUPPORT |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | PRESIDENT |
Authorized Official - Prefix: | |
Authorized Official - First Name: | TIFFANY |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | HILL |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 919-917-8330 |
Mailing Address - Street 1: | 4801 GLENWOOD AVE STE 200 |
Mailing Address - Street 2: | |
Mailing Address - City: | RALEIGH |
Mailing Address - State: | NC |
Mailing Address - Zip Code: | 27612-3857 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 919-917-8330 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 4801 GLENWOOD AVE STE 200 |
Practice Address - Street 2: | |
Practice Address - City: | RALEIGH |
Practice Address - State: | NC |
Practice Address - Zip Code: | 27612-3857 |
Practice Address - Country: | US |
Practice Address - Phone: | 919-917-8330 |
Practice Address - Fax: | |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2022-02-17 |
Last Update Date: | 2025-02-17 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 251S00000X | Agencies | Community/Behavioral Health | ||
No | 3747P1801X | Nursing Service Related Providers | Technician | Personal Care Attendant | Group - Single Specialty |
No | 385H00000X | Respite Care Facility | Respite Care | ||
No | 253Z00000X | Agencies | In Home Supportive Care | ||
No | 261QR0405X | Ambulatory Health Care Facilities | Clinic/Center | Rehabilitation, Substance Use Disorder | |
No | 276400000X | Hospital Units | Rehabilitation, Substance Use Disorder Unit | ||
No | 291U00000X | Laboratories | Clinical Medical Laboratory | ||
No | 311ZA0620X | Nursing & Custodial Care Facilities | Custodial Care Facility | Adult Care Home | |
No | 320600000X | Residential Treatment Facilities | Residential Treatment Facility, Intellectual and/or Developmental Disabilities | ||
No | 320700000X | Residential Treatment Facilities | Residential Treatment Facility, Physical Disabilities | Group - Single Specialty | |
No | 320800000X | Residential Treatment Facilities | Community Based Residential Treatment Facility, Mental Illness | ||
No | 320900000X | Residential Treatment Facilities | Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities | ||
No | 332B00000X | Suppliers | Durable Medical Equipment & Medical Supplies | ||
No | 343900000X | Transportation Services | Non-emergency Medical Transport (VAN) | ||
No | 347C00000X | Transportation Services | Private Vehicle | Group - Single Specialty |