Provider Demographics
NPI:1437942042
Name:UJIMA COMMUNITY SERVICES, PLLC
Entity type:Organization
Organization Name:UJIMA COMMUNITY SERVICES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:
Authorized Official - Last Name:JASPER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:980-229-3824
Mailing Address - Street 1:1750 HIGHWAY 160 W STE 101-311
Mailing Address - Street 2:
Mailing Address - City:FORT MILL
Mailing Address - State:SC
Mailing Address - Zip Code:29708-8009
Mailing Address - Country:US
Mailing Address - Phone:980-229-3824
Mailing Address - Fax:
Practice Address - Street 1:7504 E INDEPENDENCE BLVD STE 109
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28227-9454
Practice Address - Country:US
Practice Address - Phone:980-229-3824
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:UJIMA HEALTHCARE, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2025-05-27
Last Update Date:2025-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251S00000XAgenciesCommunity/Behavioral Health
No323P00000XResidential Treatment FacilitiesPsychiatric Residential Treatment Facility
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty