Healthcare Provider Details

I. General information

NPI: 1083887434
Provider Name (Legal Business Name): COMMUNITY ALTERNATIVE RESOURCES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/08/2008
Last Update Date: 04/08/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7303 SHIRAS CT
CHARLOTTE NC
28273-9606
US

IV. Provider business mailing address

7303 SHIRAS CT
CHARLOTTE NC
28273-9606
US

V. Phone/Fax

Practice location:
  • Phone: 704-345-2032
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code302F00000X
TaxonomyExclusive Provider Organization
License Number
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code305R00000X
TaxonomyPreferred Provider Organization
License Number
License Number StateNC

VIII. Authorized Official

Name: MR. WAYNE LEVONNE BURCH SR.
Title or Position: EXECUTIVE DIRECTOR
Credential: MBA, QP
Phone: 704-345-2032