Provider Demographics
NPI:1063679637
Name:HEARTFELT ALTERNATIVES, INC.
Entity Type:Organization
Organization Name:HEARTFELT ALTERNATIVES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:TABATHA
Authorized Official - Middle Name:EVA
Authorized Official - Last Name:MOORE
Authorized Official - Suffix:
Authorized Official - Credentials:MSW, PLCSW
Authorized Official - Phone:919-844-7770
Mailing Address - Street 1:1100 LOGGER CT
Mailing Address - Street 2:SUITE C100
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27609-8525
Mailing Address - Country:US
Mailing Address - Phone:919-844-7770
Mailing Address - Fax:919-844-7771
Practice Address - Street 1:1100 LOGGER CT
Practice Address - Street 2:SUITE C100
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27609-8525
Practice Address - Country:US
Practice Address - Phone:919-844-7770
Practice Address - Fax:919-844-7771
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-20
Last Update Date:2013-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X, 320800000X
NCPOO4120251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251S00000XAgenciesCommunity/Behavioral Health
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6006422Medicaid
NC8302448VMedicaid
NC5915562Medicaid
NC8302448HMedicaid
NC6604434Medicaid