Provider Demographics
NPI:1154014439
Name:SUPPORTIVE SOLUTIONS NC LLC
Entity type:Organization
Organization Name:SUPPORTIVE SOLUTIONS NC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DANIELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:RODRIGUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:630-212-1051
Mailing Address - Street 1:PO BOX 1001
Mailing Address - Street 2:
Mailing Address - City:RICHFIELD
Mailing Address - State:NC
Mailing Address - Zip Code:28137-1006
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:212 STATE HWY 49 N
Practice Address - Street 2:#1001
Practice Address - City:RICHFIELD
Practice Address - State:NC
Practice Address - Zip Code:28137
Practice Address - Country:US
Practice Address - Phone:630-212-1051
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-01
Last Update Date:2023-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty