| Comprehensive Community Supportive Services Pllc | |
|
350 Holly Hill Ln Ste 350 Burlington NC 27215-5691 | |
| (844) 562-2777 | |
| (336) 350-7737 |
| Full Name | Comprehensive Community Supportive Services Pllc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 350 Holly Hill Ln Ste 350, Burlington, North Carolina |
| Authorized Official Name and Position | Jennifer Denece Wilson (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 8445622777 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Comprehensive Community Supportive Services Pllc 350 Holly Hill Ln Ste 350 Burlington NC 27215-5691 Ph: () - | Comprehensive Community Supportive Services Pllc 350 Holly Hill Ln Ste 350 Burlington NC 27215-5691 Ph: (844) 562-2777 |
| NPI Number | 1578014429 |
|---|---|
| Provider Enumeration Date | 10/16/2016 |
| Last Update Date | 01/03/2019 |
| Medicare PECOS PAC ID | 5597046144 |
|---|---|
| Medicare Enrollment ID | O20161220000561 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1578014429 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | (* (Not Available)) | Secondary |
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| Provider Name | Jennifer D Wilson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1063834919 PECOS PAC ID: 9931480589 Enrollment ID: I20161220000762 |
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