Provider Demographics
NPI:1164384087
Name:UNLIMITED SUPPORTS & CONSULTING AGENCY LLC
Entity type:Organization
Organization Name:UNLIMITED SUPPORTS & CONSULTING AGENCY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LATOYA
Authorized Official - Middle Name:CELESTE
Authorized Official - Last Name:TATE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:336-303-6922
Mailing Address - Street 1:5103 MALLISON WAY
Mailing Address - Street 2:
Mailing Address - City:MC LEANSVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27301-9004
Mailing Address - Country:US
Mailing Address - Phone:336-303-6922
Mailing Address - Fax:336-303-6922
Practice Address - Street 1:5103 MALLISON WAY
Practice Address - Street 2:
Practice Address - City:MC LEANSVILLE
Practice Address - State:NC
Practice Address - Zip Code:27301-9004
Practice Address - Country:US
Practice Address - Phone:336-303-6922
Practice Address - Fax:336-303-6922
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-12-01
Last Update Date:2025-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Multi-Specialty