Organization
AMAZING COMMUNITY SUPPORT SERVICES INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KARENA K NELSON (ADMINISTRATOR)
(910) 630-2025
Entity
Organization
Contact information
Practice address
111 LAMON ST, FAYETTEVILLE, NC 28301-4901
(910) 630-2025
(910) 630-2057
Mailing address
111 LAMON ST, FAYETTEVILLE, NC 28301-4901
(910) 630-2025
(910) 630-2057
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
111111
—
NC
Enumeration date
01/12/2009
Last updated
01/12/2009
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