Provider Demographics
NPI:1538368162
Name:UNIVERSAL SERVICES AND ASSOCIATES DBA CAROLINA HEALTHCARE SYSTEMS, LLC
Entity type:Organization
Organization Name:UNIVERSAL SERVICES AND ASSOCIATES DBA CAROLINA HEALTHCARE SYSTEMS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AGENCY DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:DENISE
Authorized Official - Last Name:MCLAIN
Authorized Official - Suffix:
Authorized Official - Credentials:RN, BSN
Authorized Official - Phone:336-397-0091
Mailing Address - Street 1:301 N MAIN ST
Mailing Address - Street 2:SUITE 2501
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27101-3836
Mailing Address - Country:US
Mailing Address - Phone:336-397-0091
Mailing Address - Fax:336-397-0097
Practice Address - Street 1:123 E MARTIN ST
Practice Address - Street 2:SUITE 300
Practice Address - City:WADESBORO
Practice Address - State:NC
Practice Address - Zip Code:28170-2216
Practice Address - Country:US
Practice Address - Phone:336-397-0091
Practice Address - Fax:336-397-0097
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-13
Last Update Date:2007-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCHC3361251J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care