Healthcare Provider Details

I. General information

NPI: 1497786982
Provider Name (Legal Business Name): THERAPEUTIC ALTERNATIVES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/05/2006
Last Update Date: 08/13/2026
Certification Date: 08/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2910 FOREST PARK DR
RANDLEMAN NC
27317-7470
US

IV. Provider business mailing address

PO BOX 814
RANDLEMAN NC
27317-0814
US

V. Phone/Fax

Practice location:
  • Phone: 336-495-6782
  • Fax: 336-495-6782
Mailing address:
  • Phone: 336-495-2700
  • Fax: 336-495-5552

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code311ZA0620X
TaxonomyAdult Care Home Facility
License NumberMHL 076 011
License Number StateNC

VIII. Authorized Official

Name: DAVID DEAN WILSON
Title or Position: OWNER
Credential:
Phone: 336-495-2700