Organization
HABILITATION AND SUPPORT SERVICES, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. TANZY B. WALLACE (DIRECTOR OF OPERATIONS)
(704) 482-0299
Entity
Organization
Contact information
Practice address
704 W WARREN ST, SHELBY, NC 28150-5022
(704) 482-0299
(704) 487-5635
Mailing address
PO BOX 596, SHELBY, NC 28151-0596
(704) 482-0299
(704) 487-5635
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8300178
—
NC
Enumeration date
06/20/2007
Last updated
08/22/2020
Update your record
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