Basic Information
| Provider Information | |||||||||
| NPI: | 1316063456 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | CNC/ACCESS, INC. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 9901 LINN STATION RD | ||||||||
| Address2: | |||||||||
| City: | LOUISVILLE | ||||||||
| State: | KY | ||||||||
| PostalCode: | 402233808 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8008660860 | ||||||||
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| Practice Location | |||||||||
| Address1: | 617 S GREEN ST | ||||||||
| Address2: | SUITE 300 | ||||||||
| City: | MORGANTON | ||||||||
| State: | NC | ||||||||
| PostalCode: | 286553517 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8284338181 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 03/21/2007 | ||||||||
| LastUpdateDate: | 11/19/2009 | ||||||||
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| AuthorizedOfficialLastName: | OMBRES | ||||||||
| AuthorizedOfficialFirstName: | DEENA | ||||||||
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| AuthorizedOfficialTitleorPosition: | PRIVACY OFFICER | ||||||||
| AuthorizedOfficialTelephone: | 5023942387 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MS. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 251B00000X | N | Agencies | Case Management | 251C00000X | N | Agencies | Day Training, Developmentally Disabled Services | 251E00000X | N | Agencies | Home Health | 251S00000X | Y | Agencies | Community/Behavioral Health |
ID Information
| ID | Type | State | Issuer | Description | 5902504 | 05 | NC | MEDICAID | 6005524 | 05 | NC | MEDICAID | 6600528 | 05 | NC | MEDICAID | 6600720 | 05 | NC | MEDICAID | 8300520 | 05 | NC | MEDICAID | 8300520B | 05 | NC | MEDICAID | 8300522 | 05 | NC | MEDICAID | 8300528B | 05 | NC | MEDICAID | 8300499 | 05 | NC | MEDICAID | 8300522G | 05 | NC | MEDICAID | 8300534B | 05 | NC | MEDICAID | 5904334 | 05 | NC | MEDICAID | 6005522 | 05 | NC | MEDICAID | 6005616 | 05 | NC | MEDICAID | 6600192 | 05 | NC | MEDICAID | 6601177 | 05 | NC | MEDICAID | 8300522B | 05 | NC | MEDICAID | 8300524 | 05 | NC | MEDICAID | 8300524B | 05 | NC | MEDICAID | 8300646 | 05 | NC | MEDICAID | 8300500 | 05 | NC | MEDICAID | 8300524G | 05 | NC | MEDICAID | 8300526 | 05 | NC | MEDICAID | 8300646B | 05 | NC | MEDICAID | 8300787B | 05 | NC | MEDICAID | 5902409 | 05 | NC | MEDICAID | 8300534 | 05 | NC | MEDICAID | 6005557 | 05 | NC | MEDICAID | 8300500G | 05 | NC | MEDICAID | 8300520G | 05 | NC | MEDICAID | 8300523 | 05 | NC | MEDICAID | 8300523B | 05 | NC | MEDICAID | 8300524H | 05 | NC | MEDICAID | 8300528 | 05 | NC | MEDICAID | 8300787G | 05 | NC | MEDICAID | 5902716 | 05 | NC | MEDICAID | 6005525 | 05 | NC | MEDICAID | 6005757 | 05 | NC | MEDICAID | 6600195 | 05 | NC | MEDICAID | 8300499B | 05 | NC | MEDICAID | 8300499G | 05 | NC | MEDICAID | 8300523G | 05 | NC | MEDICAID | 5902408 | 05 | NC | MEDICAID | 5902427 | 05 | NC | MEDICAID | 6005617 | 05 | NC | MEDICAID | 8300534G | 05 | NC | MEDICAID | 8300787 | 05 | NC | MEDICAID |