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Organization
SUPPORT INCORPORATED
Active
Organization
SUPPORT INCORPORATED
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MIKE MCNEAL (DIRECTOR OF OPERATIONS)
(704) 865-3525
Entity
Organization
Contact information
Practice address
1243 E DIXON BLVD STE 4, SHELBY, NC 28152-6893
(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
251B00000X
Case Management Agency
—
—
251C00000X
Developmentally Disabled Services Day Training Agency
MHL-023-078
NC
251S00000X
Community/Behavioral Health Agency
Primary
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
MHL-023-078
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8300642
—
NC
05
—
8300642B
—
NC
05
—
8300642R
—
NC
Enumeration date
02/09/2007
Last updated
01/07/2008
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