MEDICARE: ALANA ROSE

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	103K00000X	Behavior Analyst
2	106E00000X	Assistant Behavior Analyst
3	261QM0855X	Adolescent and Children Mental Health Clinic/Center
4	3104A0630X	Assisted Living Facility (Behavioral Disturbances)
5	322D00000X	Emotionally Disturbed Childrens' Residential Treatment Facility
6	385HR2060X	Child Intellectual and/or Developmental Disabilities Respite Care
7	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1306560065
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALANA ROSE

Provider Business Mailing Address
First Line	:	4344 ABERNATHY PL
Second Line	:
City	:	HARRISBURG
State	:	NC
Zip	:	28075-6695
Country	:	US
Telephone Number	:	980-260-9163
Fax Number	:

Provider Business Practice Location Address
First Line	:	2807 YURMAN RD
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28214-5605
Country	:	US
Telephone Number	:	980-260-9163
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/27/2022
Last Update Date	:	09/27/2022

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Directions to “ ALANA ROSE ” Practice Location

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