Basic Information
| Provider Information | |||||||||
| NPI: | 1578682191 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | A UNITED COMMUNITY, LLC | ||||||||
| LastName: | |||||||||
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| OtherOrganizationName: | UNITED COMMUNITY PARTNERS, LLC | ||||||||
| OtherOrganizationType: | 4 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4020 WAKE FOREST RD | ||||||||
| Address2: | SUITE 301 | ||||||||
| City: | RALEIGH | ||||||||
| State: | NC | ||||||||
| PostalCode: | 276096866 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9198181590 | ||||||||
| FaxNumber: | 9198781593 | ||||||||
| Practice Location | |||||||||
| Address1: | 4020 WAKE FOREST RD | ||||||||
| Address2: | SUITE 301 | ||||||||
| City: | RALEIGH | ||||||||
| State: | NC | ||||||||
| PostalCode: | 276096866 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9198781590 | ||||||||
| FaxNumber: | 9198781593 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/28/2007 | ||||||||
| LastUpdateDate: | 04/04/2014 | ||||||||
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| AuthorizedOfficialLastName: | BRADLEY | ||||||||
| AuthorizedOfficialFirstName: | LISA | ||||||||
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| AuthorizedOfficialTitleorPosition: | EXECUTIVE DIRECTOR | ||||||||
| AuthorizedOfficialTelephone: | 9198781590 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 251B00000X | N | Agencies | Case Management | 253Z00000X | N | Agencies | In Home Supportive Care | 251E00000X | N | Agencies | Home Health | 103TB0200X | N | 193200000X MULTI-SPECIALTY GROUP | Behavioral Health & Social Service Providers | Psychologist | Cognitive & Behavioral | 103TP0016X | N | 193200000X MULTI-SPECIALTY GROUP | Behavioral Health & Social Service Providers | Psychologist | Prescribing (Medical) | 363AM0700X | N | 193200000X MULTI-SPECIALTY GROUP | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | Medical | 251S00000X | Y | Agencies | Community/Behavioral Health |
No ID Information.