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NPI Code Detail

MEDICARE: MADISON COMMUNITY ALTERNATIVES INC

MEDICARE: MADISON COMMUNITY ALTERNATIVES INC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1251S00000XCommunity/Behavioral Health Agency

General Provider Information

NPI Number : 1215202155
Entity Type Code : Organization
Provider Name (Legal Business Name) : MADISON COMMUNITY ALTERNATIVES INC
Provider Business Mailing Address
First Line : PO BOX 561537
Second Line :
City : CHARLOTTE
State : NC
Zip : 28256-1537
Country : US
Telephone Number : 704-549-9800
Fax Number : 704-549-9888
Provider Business Practice Location Address
First Line : 528 S CASINO CENTER BLVD
Second Line : SUITE 300
City : LAS VEGAS
State : NV
Zip : 89101-6526
Country : US
Telephone Number : 704-549-9800
Fax Number : 704-549-9888
Authorized Official
Title or Position : DIRECTOR OF OPERATIONS
Name : SABRINA BETTS
Credential :
Telephone Number : 704-549-9800
Provider Enumeration Date : 03/10/2012
Last Update Date : 03/10/2012

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Directions to “MADISON COMMUNITY ALTERNATIVES INC ” Practice Location

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