Organization
SUPPORT STAFF INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CARLEY JEGBADAI RN (ADMINISTRATOR)
(919) 790-1953
Entity
Organization
Contact information
Practice address
2805 SPRING FOREST RD, SUITE 201, RALEIGH, NC 27616
(919) 790-1953
(919) 790-1963
Mailing address
2805 SPRING FOREST RD, SUITE 201, RALEIGH, NC 27616-1899
(919) 790-1953
(919) 790-1963
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
HC2558
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6601157
—
NC
05
—
6601351
—
NC
05
—
6601352
—
NC
05
—
6601408
—
NC
05
—
6601524
—
NC
Enumeration date
03/16/2007
Last updated
08/22/2020
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