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General NPI Number Information
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NPI Number | 1467281386
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Entity Type | Organization
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Legal Business Name | ALSTON BRIGHT START MENTAL HEALTH
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Dates
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Enumeration Date | 07/30/2024
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Last Update Date | 10/24/2024
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Provider Practice Location Address
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Address Line | 134 PARKTOWN RD
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City | WARRENTON
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State | NC
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Zip | 27589-9153
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Country | US
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Telephone | 919-438-5738
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Fax |
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Provider Business Mailing Address
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Address Line | 5504 HERALDY CT
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City | KNIGHTDALE
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State | NC
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Zip | 27545-7692
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Country | US
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Telephone | 919-438-5738
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Fax |
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Authorized Official
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Title or Position | HABILITATION TECH
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Name | TONYA MARIE ALSTON
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Credential |
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Telephone | 919-438-5738
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 175T00000X
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Taxonomy Name | Peer Specialist
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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 | 320900000X
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Taxonomy Name | Intellectual and/or Developmental Disabilities 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 | 385H00000X
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Taxonomy Name | Respite Care
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License Number |
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License Number State |
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Taxonomy #4
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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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