Provider Demographics
NPI:1215202155
Name:MADISON COMMUNITY ALTERNATIVES INC
Entity Type:Organization
Organization Name:MADISON COMMUNITY ALTERNATIVES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:SABRINA
Authorized Official - Middle Name:
Authorized Official - Last Name:BETTS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-549-9800
Mailing Address - Street 1:PO BOX 561537
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28256-1537
Mailing Address - Country:US
Mailing Address - Phone:704-549-9800
Mailing Address - Fax:704-549-9888
Practice Address - Street 1:528 S CASINO CENTER BLVD
Practice Address - Street 2:SUITE 300
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89101-6526
Practice Address - Country:US
Practice Address - Phone:704-549-9800
Practice Address - Fax:704-549-9888
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-10
Last Update Date:2012-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health