| Community Support Agency, Llc | |
|
44 Dream Ave Delco NC 28436-8700 | |
| (910) 297-4230 | |
| (910) 297-4230 |
| Full Name | Community Support Agency, Llc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 44 Dream Ave, Delco, North Carolina |
| Authorized Official Name and Position | Devoria Keaton Berry (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 9106550698 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Community Support Agency, Llc P.o Box 465 Delco NC 28436-9221 Ph: (910) 655-0698 | Community Support Agency, Llc 44 Dream Ave Delco NC 28436-8700 Ph: (910) 297-4230 |
| NPI Number | 1447393020 |
|---|---|
| Provider Enumeration Date | 02/14/2007 |
| Last Update Date | 10/16/2018 |
| Medicare PECOS PAC ID | 5294916730 |
|---|---|
| Medicare Enrollment ID | O20110216001043 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1447393020 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| Provider Name | Devoria Berry |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1942672761 PECOS PAC ID: 0042491185 Enrollment ID: I20180906000241 |
Professional Consulting & Counseling Services Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 27056 Andrew Jackson Hwy E, Delco, NC 28436 Phone: 910-297-4230 Fax: 910-655-0611 | |
Access Nc, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 2957 Old Stage Rd, Delco, NC 28436 Phone: 919-460-8522 Fax: 919-460-8502 |