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Organization

A STORM COMMUNITY SUPPORT

Active
Organization subpart
No

Provider details

NPI number
Authorized official
TIFFANY HILL (MANAGER)
(919) 917-8330
Entity
Organization

Contact information

Practice address
4801 GLENWOOD AVE STE 200, RALEIGH, NC 27612-3857
(919) 917-8330
Mailing address
4801 GLENWOOD AVE STE 200, RALEIGH, NC 27612-3857
(919) 917-8330

Taxonomy

Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
253Z00000X
In Home Supportive Care Agency
291U00000X
Clinical Medical Laboratory
Primary
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
347C00000X
Private Vehicle

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
502338
NC
Enumeration date
07/10/2023
Last updated
10/08/2023
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