1962804690 NPI number — RESIDENTIAL SERVICES, INC.

Table of content: (NPI 1962804690)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1962804690 NPI number — RESIDENTIAL SERVICES, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
RESIDENTIAL 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:
1962804690
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/25/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
111 PROVIDENCE RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CHAPEL HILL
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
27514-2229
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
919-942-7391
Provider Business Mailing Address Fax Number:
919-933-4490

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
106 ABERDEEN CT
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CARRBORO
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
27510-1218
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
919-967-9531
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/25/2014

Additional Information

Authorized Official

Authorized Official Last Name:
KELLER
Authorized Official First Name:
SCOTT
Authorized Official Middle Name:
A
Authorized Official Title or Position:
EXECUTIVE DIRECTOR
Authorized Official Telephone Number:
919-942-7391

Provider Taxonomy Codes

  • Taxonomy code: 251S00000X , with the licence number:  MHL-068-093 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 3406331 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 7804543 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 7804546 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 7804547 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 7806709 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 3406544 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 7804548 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 7804896 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 7805754 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 3406482 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 3406356 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 8300572 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 340603P , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 340610U , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 3408164 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 7804544 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 7804545 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 7806030 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".




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