Healthcare Provider Details

I. General information

NPI: 1710116850
Provider Name (Legal Business Name): THERAPEUTIC ALTERNATIVES INCORPORATED
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/10/2009
Last Update Date: 04/21/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4024 BARRETT DR STE 101
RALEIGH NC
27609-6625
US

IV. Provider business mailing address

PO BOX 814
RANDLEMAN NC
27317-0814
US

V. Phone/Fax

Practice location:
  • Phone: 919-896-7906
  • Fax: 919-896-7908
Mailing address:
  • Phone: 336-495-2700
  • Fax: 336-495-5552

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: KENNETH A BURROW
Title or Position: CEO
Credential:
Phone: 336-495-2700