Provider Demographics
NPI:1831333723
Name:UNITED DAY SUPPORT SERVICES
Entity type:Organization
Organization Name:UNITED DAY SUPPORT SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:DARRIN
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:MCNEILL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:910-583-1104
Mailing Address - Street 1:535 BUNCE ROAD
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28314-2903
Mailing Address - Country:US
Mailing Address - Phone:910-583-1104
Mailing Address - Fax:
Practice Address - Street 1:535 BUNCE ROAD
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28314-2903
Practice Address - Country:US
Practice Address - Phone:910-583-1104
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:UNITED RESIDENTIAL SERVICES OF N.C.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-04-23
Last Update Date:2009-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCMHL026872302F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302F00000XManaged Care OrganizationsExclusive Provider Organization