Provider Demographics
NPI:1063788040
Name:STANDARD ABOVE ALL, INC.
Entity type:Organization
Organization Name:STANDARD ABOVE ALL, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHANITTA
Authorized Official - Middle Name:RENEE
Authorized Official - Last Name:BROOKS
Authorized Official - Suffix:
Authorized Official - Credentials:BSW, QP
Authorized Official - Phone:252-969-1934
Mailing Address - Street 1:200 BANNER WAY
Mailing Address - Street 2:
Mailing Address - City:ROCKY MOUNT
Mailing Address - State:NC
Mailing Address - Zip Code:27804-3456
Mailing Address - Country:US
Mailing Address - Phone:252-969-1934
Mailing Address - Fax:252-210-9171
Practice Address - Street 1:656 HAGGERTY TRL
Practice Address - Street 2:
Practice Address - City:ROCKY MOUNT
Practice Address - State:NC
Practice Address - Zip Code:27803-9134
Practice Address - Country:US
Practice Address - Phone:252-210-3157
Practice Address - Fax:252-210-9171
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-23
Last Update Date:2012-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC174H00000X, 320600000X, 320800000X, 385H00000X, 320700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes320700000XResidential Treatment FacilitiesResidential Treatment Facility, Physical DisabilitiesGroup - Multi-Specialty
No174H00000XOther Service ProvidersHealth EducatorGroup - Multi-Specialty
No320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities
No320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness
No385H00000XRespite Care FacilityRespite Care