| Carolina Supportive Living Llc | |
|
1259 E Main St Old Fort NC 28762-5768 | |
| (828) 470-8642 | |
| Not Available |
| Full Name | Carolina Supportive Living Llc |
|---|---|
| Speciality | Non-emergency Medical Transport (van) |
| Location | 1259 E Main St, Old Fort, North Carolina |
| Authorized Official Name and Position | Omecia Margaritta Ponder (OWNER/ADMINISTRATOR) |
| Authorized Official Contact | 8287475978 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Carolina Supportive Living Llc 1259 E Main St Old Fort NC 28762-5768 Ph: (828) 470-8642 | Carolina Supportive Living Llc 1259 E Main St Old Fort NC 28762-5768 Ph: (828) 470-8642 |
| NPI Number | 1245179019 |
|---|---|
| Provider Enumeration Date | 03/26/2026 |
| Last Update Date | 07/07/2026 |
| Certification Date | 07/07/2026 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1245179019 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Secondary |
| 343900000X | Non-emergency Medical Transport (van) | (* (Not Available)) | Primary |
Wings Of Flight Center For Change, Pllc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 118 Ebenezer Rd, Old Fort, NC 28762 Phone: 828-407-0880 |