Organization
COMMON GROUND SUPPORT
Active
Other names
Common Ground Support
Organization subpart
No
Provider details
NPI number
Authorized official
JORDAN TYRONE ROGERS (OWNER)
(732) 685-2991
Entity
Organization
Contact information
Practice address
699 SALISBURY RD, HENDERSONVILLE, NC 28792-8524
(732) 685-2991
Mailing address
622 FREMONT AVE, DAYTONA BEACH, FL 32114-6071
(732) 685-2991
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
171M00000X
Case Manager/Care Coordinator
—
—
Other
Enumeration date
08/25/2023
Last updated
09/01/2023
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