Provider Demographics
NPI:1730380817
Name:RESIDENTIAL SUPPORT SERVICES OF WAKE COUNTY, INC.
Entity type:Organization
Organization Name:RESIDENTIAL SUPPORT SERVICES OF WAKE COUNTY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE ASSISTANT
Authorized Official - Prefix:
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:
Authorized Official - Last Name:MURRAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-787-1214
Mailing Address - Street 1:PO BOX 98476
Mailing Address - Street 2:185 WIND CHIME COURT SUITE 101
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27624-8476
Mailing Address - Country:US
Mailing Address - Phone:919-787-1214
Mailing Address - Fax:919-787-3416
Practice Address - Street 1:185 WIND CHIME CT
Practice Address - Street 2:SUITE 101
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27615-6481
Practice Address - Country:US
Practice Address - Phone:919-787-1214
Practice Address - Fax:919-787-3416
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-29
Last Update Date:2013-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8702203Medicaid
NC7804510Medicaid
NC7804509Medicaid
NC3418153Medicaid
NC8300856BMedicaid
NC7804508Medicaid
NC8300856Medicaid