| A-1 Community Support Llc | |
|
523 S Chestnut St Henderson NC 27536-4102 | |
| (252) 433-0255 | |
| (252) 436-6575 |
| Full Name | A-1 Community Support Llc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 523 S Chestnut St, Henderson, North Carolina |
| Authorized Official Name and Position | Dwaylon Vondwell Whitley (OWNER) |
| Authorized Official Contact | 9196494757 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| A-1 Community Support Llc 523 S Chestnut St Henderson NC 27536-4102 Ph: (252) 433-0255 | A-1 Community Support Llc 523 S Chestnut St Henderson NC 27536-4102 Ph: (252) 433-0255 |
| NPI Number | 1609926112 |
|---|---|
| Provider Enumeration Date | 01/10/2007 |
| Last Update Date | 01/22/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609926112 | NPI | - | NPPES |
| 8302336 | Medicaid | NC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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