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Organization
SUPPORT INC.
Active
Organization
SUPPORT INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MIKE MCNEAL (DIRECTOR OF OPERATIONS)
(704) 865-3525
Entity
Organization
Contact information
Practice address
209 W 2ND AVE, GASTONIA, NC 28052-4076
(704) 865-3525
(704) 865-3520
Mailing address
PO BOX 4003, GASTONIA, NC 28054-0020
(704) 865-3525
(704) 865-3520
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8300032
—
NC
05
—
8300032B
—
NC
05
—
8300032G
—
NC
05
—
8300032H
—
NC
05
—
8300032K
—
NC
Enumeration date
02/21/2008
Last updated
10/24/2008
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