Provider Demographics
NPI:1811522188
Name:AMAZING CARE SUPPORT SERVICES, INC
Entity type:Organization
Organization Name:AMAZING CARE SUPPORT SERVICES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:AUGUSTINE
Authorized Official - Middle Name:
Authorized Official - Last Name:IMOH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-609-0662
Mailing Address - Street 1:6924 FOX HAVEN PL
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27616-6384
Mailing Address - Country:US
Mailing Address - Phone:919-609-0662
Mailing Address - Fax:919-855-9477
Practice Address - Street 1:8601 SIX FORKS RD STE 400
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27615-2965
Practice Address - Country:US
Practice Address - Phone:919-609-0662
Practice Address - Fax:919-855-9477
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-03-07
Last Update Date:2020-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Single Specialty
No253Z00000XAgenciesIn Home Supportive CareGroup - Single Specialty