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General NPI Number Information
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NPI Number | 1477599694
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Entity Type | Organization
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Legal Business Name | THERAPEUTIC ALTERNATIVES INC
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Dates
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Enumeration Date | 06/22/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 905 HUNTER DR
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City | MOUNT AIRY
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State | NC
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Zip | 27030-3606
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Country | US
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Telephone | 336-786-9162
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Fax | 336-786-9162
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Provider Business Mailing Address
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Address Line | PO BOX 814
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City | RANDLEMAN
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State | NC
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Zip | 27317-0814
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Country | US
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Telephone | 336-495-2700
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Fax | 336-495-5552
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Authorized Official
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Title or Position | VICE PRESIDENT
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Name | MR. KENNETH ALAN BURROW
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Credential |
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Telephone | 336-495-2700
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 311ZA0620X
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Taxonomy Name | Adult Care Home Facility
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License Number | MHL086027
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License Number State | NC
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