Organization
A-1 COMMUNITY SUPPORT LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CRYSTAL DENEE' BUSH MSW, PLCSW (DIRECTOR)
(252) 915-4755
Entity
Organization
Contact information
Practice address
523 S CHESTNUT ST, HENDERSON, NC 27536-4102
(252) 433-0255
(866) 583-9593
Mailing address
523 S CHESTNUT ST, HENDERSON, NC 27536-4102
(252) 433-0255
(252) 436-6575
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5950172
—
NC
Enumeration date
12/10/2007
Last updated
11/14/2008
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