Organization
SUPREME SUPPORT SERVICES, LLC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. WOODROW MENTAR JR. (MANAGING PARTNER)
(803) 979-9014
Entity
Organization
Contact information
Practice address
220 N MAIN ST STE 500, GREENVILLE, SC 29601-2129
(803) 979-9014
Mailing address
220 N MAIN ST STE 500, GREENVILLE, SC 29601-2129
(803) 979-9014
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
—
251C00000X
Developmentally Disabled Services Day Training Agency
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
03/08/2015
Last updated
03/08/2015
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