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General NPI Number Information
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NPI Number | 1619850682
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Entity Type | Organization
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Legal Business Name | ALIS BEHAVIORAL HEALTH OF NORTH CAROLINA LLC
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Dates
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Enumeration Date | 07/28/2025
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Last Update Date | 07/28/2025
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Provider Practice Location Address
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Address Line | 5960 FAIRVIEW RD STE 300
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City | CHARLOTTE
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State | NC
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Zip | 28210-0202
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Country | US
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Telephone | 720-978-3435
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Fax |
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Provider Business Mailing Address
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Address Line | 1325 S COLORADO BLVD STE B705
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City | DENVER
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State | CO
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Zip | 80222-3383
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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 | CEO
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Name | ELI GROSS
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Credential |
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Telephone | 720-978-3435
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0855X
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Taxonomy Name | Adolescent and Children Mental Health Clinic/Center
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License Number |
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License Number State |
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