Concordia Support Services, Llc

LBN: Concordia Support Services, Llc
Concordia Support Services, Llc is an health care organization with primary practice located at 2315 Bloom Avenue Suite 2, Fayetteville NC 28304-6165. The organization recently has 4 registered licenses in different health care specialties including Agencies / Day Training, Developmentally Disabled Services, Agencies / Community/Behavioral Health, Residential Treatment Facilities / Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities, Residential Treatment Facilities / Community Based Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities. Agencies / Community/Behavioral Health is the primary health care specialty. Concordia Support Services, Llc can be contacted via phone (910) 826-8253, or through Nickelberry, Meredith via phone (910) 826-8253.

Contact Information

Primary practice address
2315 Bloom Avenue Suite 2 Fayetteville NC 28304-6165
Phone: (910) 826-8253
Fax: (910) 826-8254
Website:
Map and Directions
Authorized official contact:
Name: Nickelberry, Meredith
Phone: (910) 826-8253

Health care specialties

SpecialtyCodeLicense #State
Agencies / Day Training, Developmentally Disabled Services 251C00000X
Agencies / Community/Behavioral Health 251S00000X
Residential Treatment Facilities / Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities 320600000X MHL-067-156 North Carolina
Residential Treatment Facilities / Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities 320600000X MHL-067154 North Carolina
Residential Treatment Facilities / Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities 320600000X MHL-047-070 North Carolina
Residential Treatment Facilities / Community Based Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities 320900000X

Profile Details

NPI number 1417045188
LBN Legal business name Concordia Support Services, Llc
DBA Doing business as
Authorized official Nickelberry, Meredith
Entity Organization
Organization subpart 1 No
Enumeration date Oct 10th, 2006
Last updated Jun 25th, 2009 - about 16 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1417045188 NPPES
North Carolina MEDICAID 8300606
North Carolina MEDICAID 8301129G
North Carolina MEDICAID 6603837
North Carolina MEDICAID 8300606B
North Carolina MEDICAID 8300606G
North Carolina MEDICAID 6006251
North Carolina MEDICAID 6603570
North Carolina MEDICAID 8300604
North Carolina MEDICAID 8300605B
North Carolina MEDICAID 8301129H
North Carolina MEDICAID 6603687
North Carolina MEDICAID 8300605
North Carolina MEDICAID 5950244
North Carolina MEDICAID 8301864B
North Carolina MEDICAID 83001129B
North Carolina MEDICAID 8300604B
North Carolina MEDICAID 8301129
North Carolina MEDICAID 8301864

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