MEDICARE: CAROLINA ALTERNATIVE SERVICES 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
1	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1699008912
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CAROLINA ALTERNATIVE SERVICES INC.

Provider Business Mailing Address
First Line	:	4501 NEW BERN AVE
Second Line	:	SUITE 130-122
City	:	RALEIGH
State	:	NC
Zip	:	27610-1549
Country	:	US
Telephone Number	:	919-349-8600
Fax Number	:	919-806-4301

Provider Business Practice Location Address
First Line	:	2530 MERIDIAN PKWY
Second Line	:	SUITE 300
City	:	DURHAM
State	:	NC
Zip	:	27713-5272
Country	:	US
Telephone Number	:	919-349-8600
Fax Number	:	919-806-4301

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	DANIELLE LYNETTE TAFT
Credential	:
Telephone Number	:	919-349-8600

Provider Enumeration Date	:	09/18/2009
Last Update Date	:	09/18/2009

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