Healthcare Provider Details
I. General information
NPI: 1164468104
Provider Name (Legal Business Name): THERAPEUTIC ALTERNATIVES INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/20/2006
Last Update Date: 06/13/2013
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
941 E SALISBURY ST
ASHEBORO NC
27203-5049
US
IV. Provider business mailing address
PO BOX 814
RANDLEMAN NC
27317-0814
US
V. Phone/Fax
- Phone: 336-625-1500
- Fax: 336-625-2767
- Phone: 336-495-2700
- Fax: 336-495-5552
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 251S00000X |
| Taxonomy | Community/Behavioral Health Agency |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 311ZA0620X |
| Taxonomy | Adult Care Home Facility |
| License Number | MHL076047 |
| License Number State | NC |
VIII. Authorized Official
Name: MR.
KENNETH
ALAN
BURROW
Title or Position: VICE PRESIDENT
Credential:
Phone: 336-495-2700