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NPI Code Detail

MEDICARE: DENOME-MADRAS ALLIANCE

MEDICARE: DENOME-MADRAS ALLIANCE
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 AgencyC005921NC

General Provider Information

NPI Number : 1396067369
Entity Type Code : Organization
Provider Name (Legal Business Name) : DENOME-MADRAS ALLIANCE
Provider Business Mailing Address
First Line : 208 STONE BARN CIR
Second Line :
City : HOLLY SPRINGS
State : NC
Zip : 27540-7471
Country : US
Telephone Number : 919-384-5904
Fax Number : 800-798-2171
Provider Business Practice Location Address
First Line : 382 RALEIGH ST
Second Line :
City : HOLLY SPRINGS
State : NC
Zip : 27540-9047
Country : US
Telephone Number : 919-384-9504
Fax Number : 800-798-2171
Authorized Official
Title or Position : EXECUTIVE DIRECTOR
Name : SARAH J DENOME
Credential : LCSW
Telephone Number : 919-384-5904
Provider Enumeration Date : 02/18/2010
Last Update Date : 02/18/2010

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Directions to “DENOME-MADRAS ALLIANCE ” Practice Location

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