Provider Demographics
NPI:1275672685
Name:PREFERRED ALTERNATIVES OF TN, INC
Entity Type:Organization
Organization Name:PREFERRED ALTERNATIVES OF TN, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT & CEO
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:R
Authorized Official - Last Name:WILSON
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:910-483-5744
Mailing Address - Street 1:PO BOX 44105
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28309-4105
Mailing Address - Country:US
Mailing Address - Phone:910-483-5744
Mailing Address - Fax:910-483-5494
Practice Address - Street 1:1 VANTAGE WAY STE 100
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37228-1515
Practice Address - Country:US
Practice Address - Phone:615-259-0175
Practice Address - Fax:615-259-3770
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNL3(20)4M5-085-3042320600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN00941 M5Medicaid
TN00929 E2Medicaid