1578726113 NPI number — COMMUNITY ALTERNATIVES INC.

Table of content: (NPI 1578726113)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1578726113 NPI number — COMMUNITY ALTERNATIVES INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
COMMUNITY ALTERNATIVES INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
COMMUNITY CHOICES INC
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1578726113
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/01/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5800 EXECUTIVE CENTER DR STE 100
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CHARLOTTE
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
28212-8859
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
704-336-4844
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2634 CHAPEL HILL BLVD STE 11
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
DURHAM
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
27707
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
919-490-6900
Provider Business Practice Location Address Fax Number:
919-490-3087
Provider Enumeration Date:
07/03/2008

Additional Information

Authorized Official

Authorized Official Last Name:
FULK
Authorized Official First Name:
MISTY
Authorized Official Middle Name:
Authorized Official Title or Position:
VP, QUALITY & SERVICE INTEGRATION
Authorized Official Telephone Number:
704-533-0166

Provider Taxonomy Codes

  • Taxonomy code: 251S00000X , with the licence number:  MHL032391 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 251S00000X , with the licence number: MHL-032-390 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 251S00000X , with the licence number: MHL-032-391 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 251S00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 52-A CHAPEL HILL RD . This is a "IPRS" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".
  • Identifier: 55-D CHAPEL HILL RD . This is a "IPRS" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".
  • Identifier: 59-A CHAPEL HILL RD . This is a "IPRS" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".
  • Identifier: 54B CHAPEL HILL RD . This is a "IPRS" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".
  • Identifier: 60-B CHAPEL HILL RD . This is a "IPRS" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".
  • Identifier: 8301970P , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 36-A CHAPEL HILL RD . This is a "IPRS" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".
  • Identifier: 8301970B , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 36-D CHAPEL HILL RD . This is a "IPRS" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".
  • Identifier: 8301970G , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 8301970 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2024 www.npivalidator.com