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Organization

FIVE STAR SUPPORT SERVICES LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. MARIE LEGGETT MANGRUM (OWNER - DIRECTOR)
(704) 243-2592
Entity
Organization

Contact information

Practice address
9019 RED BUD TRAIL, WAXHAW, NC 28173-8913
(704) 243-2592
(704) 243-2592
Mailing address
9019 RED BUD TRAIL, WAXHAW, NC 28173-8913
(704) 243-2592
(704) 243-2592

Taxonomy

Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
NC

Other

Enumeration date
06/16/2010
Last updated
07/21/2022
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