1740457019 NPI number — UNIQUE CARE INTERVENTION SERVICES,INC

Table of content: (NPI 1740457019)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1740457019 NPI number — UNIQUE CARE INTERVENTION SERVICES,INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
UNIQUE CARE INTERVENTION SERVICES,INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1740457019
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/14/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
149 RABBIT HARE RD
Provider Second Line Business Mailing Address:
SUITE 1
Provider Business Mailing Address City Name:
ROCKINGHAM
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
28379-7661
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
910-461-7162
Provider Business Mailing Address Fax Number:
336-232-1498

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
149 RABBIT HARE RD
Provider Second Line Business Practice Location Address:
SUITE 1
Provider Business Practice Location Address City Name:
ROCKINGHAM
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28379-7661
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
910-461-7162
Provider Business Practice Location Address Fax Number:
336-232-1498
Provider Enumeration Date:
05/14/2008

Additional Information

Authorized Official

Authorized Official Last Name:
HERNDON
Authorized Official First Name:
WHITNEY
Authorized Official Middle Name:
FARRON
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
910-461-7162

Provider Taxonomy Codes

  • Taxonomy code: 251B00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 251S00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2025 www.npivalidator.com