Organization
ESSENTIAL SUPPORTIVE SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. CRYSTAL A GOLDSTON (OFFICER)
(919) 550-0639
Entity
Organization
Contact information
Practice address
112 S ELLINGTON ST, CLAYTON, NC 27520-2306
(919) 550-0639
Mailing address
112 S. ELLINGTON ST., CLAYTON, NC 27520-6566
(919) 550-0639
(919) 550-0993
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
—
251K00000X
Public Health or Welfare Agency
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
01/22/2009
Last updated
11/07/2016
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