Provider Demographics
NPI:1235465766
Name:ALTERNATE THEAPEUTIC SOLUTIONS, LLC
Entity Type:Organization
Organization Name:ALTERNATE THEAPEUTIC SOLUTIONS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF OPERATING OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:VANDA
Authorized Official - Middle Name:
Authorized Official - Last Name:THEOPHIN-MICHEL
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:919-339-8611
Mailing Address - Street 1:2921 CREEK MOSS AVE
Mailing Address - Street 2:
Mailing Address - City:WAKE FOREST
Mailing Address - State:NC
Mailing Address - Zip Code:27587-4886
Mailing Address - Country:US
Mailing Address - Phone:919-339-8611
Mailing Address - Fax:919-435-0895
Practice Address - Street 1:6233 HARRY DR
Practice Address - Street 2:SUITE D
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70806-2559
Practice Address - Country:US
Practice Address - Phone:225-636-5817
Practice Address - Fax:866-507-9329
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-18
Last Update Date:2011-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA2149059Medicaid