MEDICARE: COMMUNITY ADULT SERVICES, INCORPORATED

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1538321211
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COMMUNITY ADULT SERVICES, INCORPORATED

Provider Business Mailing Address
First Line	:	PO BOX 37464
Second Line	:
City	:	RALEIGH
State	:	NC
Zip	:	27627-7464
Country	:	US
Telephone Number	:	919-641-8010
Fax Number	:

Provider Business Practice Location Address
First Line	:	4909 WATERS EDGE DR
Second Line	:	SUITE 204
City	:	RALEIGH
State	:	NC
Zip	:	27606-2462
Country	:	US
Telephone Number	:	919-641-8010
Fax Number	:

Authorized Official
Title or Position	:	FOUNDER/PRESIDENT
Name	:	ALVINETRIS L MIDGETTE
Credential	:
Telephone Number	:	919-641-8010

Provider Enumeration Date	:	06/25/2008
Last Update Date	:	06/25/2008

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