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General NPI Number Information
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NPI Number | 1063679637
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Entity Type | Organization
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Legal Business Name | HEARTFELT ALTERNATIVES, INC.
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Dates
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Enumeration Date | 05/20/2008
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Last Update Date | 07/23/2013
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Provider Practice Location Address
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Address Line | 1100 LOGGER CT SUITE C100
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City | RALEIGH
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State | NC
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Zip | 27609-8525
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Country | US
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Telephone | 919-844-7770
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Fax | 919-844-7771
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Provider Business Mailing Address
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Address Line | 1100 LOGGER CT SUITE C100
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City | RALEIGH
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State | NC
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Zip | 27609-8525
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Country | US
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Telephone | 919-844-7770
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Fax | 919-844-7771
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Authorized Official
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Title or Position | PRESIDENT
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Name | MS. TABATHA EVA MOORE
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Credential | MSW, PLCSW
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Telephone | 919-844-7770
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 320800000X
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Taxonomy Name | Mental Illness Community Based Residential Treatment Facility
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | POO4120
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License Number State | NC
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