Organization
COMMUNITY SUPPORT SPECIALISTS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. ANNIE DELLA KENION RN (DIRECTOR/QUALIFIED PROFESSIONAL)
(910) 763-3644
Entity
Organization
Contact information
Practice address
1316 S 16TH ST, WILMINGTON, NC 28401-6422
(910) 763-3644
(910) 763-3634
Mailing address
1316 S 16TH ST, WILMINGTON, NC 28401-6422
(910) 763-3644
(910) 763-3634
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6106835
—
NC
05
—
89138HR
—
NC
Enumeration date
08/13/2007
Last updated
05/18/2010
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