Organization
CAROLINA SUPPORTIVE LIVING LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
OMECIA MARGARITTA PONDER (OWNER/ADMINISTRATOR)
(828) 747-5978
Entity
Organization
Contact information
Practice address
1259 E MAIN ST, OLD FORT, NC 28762-5768
(828) 470-8642
Mailing address
1259 E MAIN ST, OLD FORT, NC 28762-5768
(828) 470-8642
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
03/26/2026
Last updated
03/26/2026
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