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General NPI Number Information
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NPI Number | 1295855690
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Entity Type | Organization
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Legal Business Name | ALPHA COUNSELING & DWI SERVICES
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Dates
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Enumeration Date | 03/30/2007
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Last Update Date | 01/03/2008
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Provider Practice Location Address
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Address Line | 132 W ELWOOD AVE
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City | RAEFORD
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State | NC
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Zip | 28376-2802
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Country | US
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Telephone | 910-875-0070
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Fax | 910-875-0072
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Provider Business Mailing Address
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Address Line | 132 W ELWOOD AVE
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City | RAEFORD
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State | NC
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Zip | 28376-2802
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Country | US
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Telephone | 910-875-0070
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Fax | 910-875-0072
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MR. GEORGE ELLIOTT
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Credential | MA, LCAS, LPC
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Telephone | 910-875-0070
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number | 4122
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 261QR0405X
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Taxonomy Name | Substance Use Disorder Rehabilitation Clinic/Center
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License Number |
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License Number State |
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