Healthcare Provider Details

I. General information

NPI: 1306882451
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

4712 BEECHCROFT DR
GREENSBORO NC
27407-4010
US

IV. Provider business mailing address

PO BOX 814
RANDLEMAN NC
27317-0814
US

V. Phone/Fax

Practice location:
  • Phone: 336-286-9537
  • Fax: 336-286-9537
Mailing address:
  • Phone: 336-495-2700
  • Fax: 336-495-5552

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code311ZA0620X
TaxonomyAdult Care Home Facility
License NumberMHL041148
License Number StateNC

VIII. Authorized Official

Name: MR. KENNETH ALAN BURROW
Title or Position: VICE PRESIDENT
Credential:
Phone: 336-495-2700