Provider Demographics
NPI:1881989036
Name:SUPPORTIVE CARE SOLUTIONS, LLC
Entity type:Organization
Organization Name:SUPPORTIVE CARE SOLUTIONS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BSW
Authorized Official - Prefix:
Authorized Official - First Name:LISA
Authorized Official - Middle Name:
Authorized Official - Last Name:MATNEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:336-225-1311
Mailing Address - Street 1:309 JIM ELLIOTT RD
Mailing Address - Street 2:
Mailing Address - City:DENTON
Mailing Address - State:NC
Mailing Address - Zip Code:27239-7965
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:56 WEST SALISBURY ST
Practice Address - Street 2:
Practice Address - City:DENTON
Practice Address - State:NC
Practice Address - Zip Code:27239
Practice Address - Country:US
Practice Address - Phone:336-225-1311
Practice Address - Fax:336-236-7515
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-16
Last Update Date:2011-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management