Healthcare Provider Details

I. General information

NPI: 1922304377
Provider Name (Legal Business Name): HEARTFELT ALTERNATIVES, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/02/2011
Last Update Date: 07/23/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1100 LOGGER CT SUITE C100
RALEIGH NC
27609-8525
US

IV. Provider business mailing address

1100 LOGGER CT SUITE C100
RALEIGH NC
27609-8525
US

V. Phone/Fax

Practice location:
  • Phone: 919-844-7770
  • Fax: 919-844-7771
Mailing address:
  • Phone: 919-844-7770
  • Fax: 919-844-7771

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QR0401X
TaxonomyComprehensive Outpatient Rehabilitation Facility (CORF)
License Number
License Number State

VIII. Authorized Official

Name: TABATHA EVA MOORE
Title or Position: DIRECTOR
Credential: PLCSW
Phone: 919-844-7770