Provider Demographics
NPI:1982313680
Name:TOTAL SUPPORTIVE SERVICES
Entity Type:Organization
Organization Name:TOTAL SUPPORTIVE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SYLVIA
Authorized Official - Middle Name:
Authorized Official - Last Name:AUSTIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:980-295-5040
Mailing Address - Street 1:PO BOX 582
Mailing Address - Street 2:
Mailing Address - City:EARL
Mailing Address - State:NC
Mailing Address - Zip Code:28038-0582
Mailing Address - Country:US
Mailing Address - Phone:980-295-5040
Mailing Address - Fax:
Practice Address - Street 1:425 CHERRYVILLE RD STE C
Practice Address - Street 2:
Practice Address - City:SHELBY
Practice Address - State:NC
Practice Address - Zip Code:28150-3651
Practice Address - Country:US
Practice Address - Phone:980-242-0359
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-21
Last Update Date:2022-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health