Organization
OMNIPRESENT SUPPORTIVE CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARIA A HICKMAN (OWNER)
(336) 624-1027
Entity
Organization
Contact information
Practice address
8007 N POINT BLVD STE A, WINSTON SALEM, NC 27106-3268
(336) 624-1027
Mailing address
8007 N POINT BLVD STE A, WINSTON SALEM, NC 27106-3268
(336) 624-1027
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
04/22/2024
Last updated
04/22/2024
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