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General NPI Number Information
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NPI Number | 1417383704
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Entity Type | Organization
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Legal Business Name | COMMUNITY ALTERNATIVE HOUSING, INC.
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Dates
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Enumeration Date | 09/19/2013
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Last Update Date | 04/07/2014
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Provider Practice Location Address
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Address Line | 2905 BREEZEWOOD AVE SUITE 104
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City | FAYETTEVILLE
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State | NC
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Zip | 28303-5503
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Country | US
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Telephone | 910-486-8989
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Fax | 910-826-3695
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Provider Business Mailing Address
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Address Line | PO BOX 87195
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City | FAYETTEVILLE
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State | NC
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Zip | 28304-7195
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | WILBERT NICHOLS III
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Credential |
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Telephone | 910-826-3694
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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