| Assured Community Services, Llc | |
|
8025 N Point Blvd Ste 221 Winston Salem NC 27106-3100 | |
| (336) 283-2699 | |
| (704) 818-4315 |
| Full Name | Assured Community Services, Llc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 8025 N Point Blvd Ste 221, Winston Salem, North Carolina |
| Authorized Official Name and Position | Laquana Richmond (COO) |
| Authorized Official Contact | 3362832699 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Assured Community Services, Llc 24 Nw Court Sq Ste 206 Graham NC 27253-2861 Ph: (336) 283-2699 | Assured Community Services, Llc 8025 N Point Blvd Ste 221 Winston Salem NC 27106-3100 Ph: (336) 283-2699 |
| NPI Number | 1053925727 |
|---|---|
| Provider Enumeration Date | 09/01/2020 |
| Last Update Date | 11/09/2021 |
| Certification Date | 11/09/2021 |
| Medicare PECOS PAC ID | 7416301015 |
|---|---|
| Medicare Enrollment ID | O20231002000535 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053925727 | NPI | - | NPPES |
| 1053925727 | Medicaid | NC |
| Provider Name | Jamee Reynolds Mack |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1790818011 PECOS PAC ID: 8729432299 Enrollment ID: I20231003000082 |
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