Provider Demographics
NPI:1033937818
Name:SUPPORTIVE SERVICES
Entity type:Organization
Organization Name:SUPPORTIVE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:IHEOMA
Authorized Official - Middle Name:NNENNA
Authorized Official - Last Name:ALARIBE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-757-3067
Mailing Address - Street 1:3064 WAKE FOREST RD # 1140
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27609-7844
Mailing Address - Country:US
Mailing Address - Phone:919-757-3067
Mailing Address - Fax:
Practice Address - Street 1:6408 WILLOW FOX CT
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27616-6359
Practice Address - Country:US
Practice Address - Phone:919-757-3067
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-30
Last Update Date:2024-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home